【摘要】：目的從解剖學角度解析頸椎橫突后結(jié)節(jié)為針刀靶點治療神經(jīng)根型頸椎病(CSR)的作用機制。方法31側(cè)CSR患者,側(cè)臥,針刀靶向橫突后結(jié)節(jié),松解其周圍結(jié)構。治療10 d后,復查患者癥狀、體征及頸椎X線變化。解剖觀察6具12側(cè)成年尸體頸椎橫突后結(jié)節(jié)周圍結(jié)構與脊神經(jīng)根的關系。結(jié)果治療10 d后,上肢麻木、疼痛癥狀明顯減輕或消失者占83.9%;臂叢神經(jīng)牽拉和椎間孔擠壓試驗轉(zhuǎn)陰率分別為84.2%和75.0%;X線檢查顯示,橫突間距和椎間外孔縱距分別增寬5.24%和15.87%。尸體解剖發(fā)現(xiàn),橫突后結(jié)節(jié)位于脊神經(jīng)根后外側(cè),其前方和側(cè)方主要為中、后斜角肌及肩胛提肌腱附著。部分起自前結(jié)節(jié)的中、后斜角肌及肩胛提肌腱,以及前斜角肌腱均跨越脊神經(jīng)溝后合并到后結(jié)節(jié)。相鄰后結(jié)節(jié)間有明顯韌帶連結(jié)。結(jié)論橫突后結(jié)節(jié)為針刀靶點治療CSR的作用機制可能是解除后結(jié)節(jié)周圍的肌腱和韌帶對神經(jīng)根的壓迫。
[Abstract]:Objective to analyze the mechanism of (CSR) treatment of cervical spondylotic radiculopathy by using posterior tubercle of transverse process of cervical spine as a target of needle knife from anatomical point of view. Methods 31 sides of CSR patients, lying side, needle-knife targeted posterior transverse tubercle, loosened the surrounding structure. After 10 days of treatment, the symptoms, signs and X-ray changes of cervical spine were reviewed. The relationship between the structures around the posterior tubercle of the transverse process of cervical spine and the spinal nerve roots in 6 adult cadavers was observed. Results after 10 days of treatment, 83.9% of the patients suffered from numbness and pain relief, and 84.2% and 75.0% of the patients had brachial plexus traction and intervertebral foramen extrusion test, respectively, and the negative rate of brachial plexus traction and intervertebral foramen extrusion test were 84.2% and 75.0%, respectively. X-ray examination showed that the distance between transverse process and lateral foramen increased by 5.24% and 15.87%, respectively. The posterolateral tubercle of the transverse process was found to be located in the posterolateral part of the spinal nerve root, and the anterior and lateral nodes were mainly middle, posterior trapezius muscle and levator scapularis tendon attached. The posterior trapezius muscle, the levator scapularis tendon, and the anterior trapezius tendon all cross the spinal sulcus and merge into the posterior tubercle. There are obvious ligamentous connections between adjacent posterior nodules. Conclusion the therapeutic mechanism of posterior transverse tubercle for CSR may be to relieve the compression of nerve roots by tendons and ligaments around the posterior tubercle.
【作者單位】： 貴州省遵義市第二人民醫(yī)院疼痛科;遵義醫(yī)學院附屬醫(yī)院藥劑科;貴州省遵義醫(yī)學院人體解剖學教研室;貴州省遵義市第二人民醫(yī)院放射科;
【基金】：國家自然科學基金應急管理項目(No:31540031) 貴州省遵義市科技局社會攻關項目(No:2013-49)
【分類號】：R246.9
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本文編號：2467953