摘要
目的:探讨颈椎手术椎动脉误伤的预防及对策。方法:32例椎动脉型颈椎病(混合型为主)行颈前路手术,12例上颈椎不稳定型损伤行颈后路手术,并对手术效果进行了临床随访观察。结果:全部手术经过顺利、疗效满意,优良率分别为93.8%及75%。术中误伤2支椎动脉,分别行缝扎及骨块外明胶海绵填塞压迫止血,未见明显椎动脉缺血症状。结论:颈前路椎体减压及椎体次全切其安全区为钩突内侧缘及两侧颈长肌内侧缘宽度在20cm。颈前路椎动脉减压术必须使用显微外科器械,具有一定手术技巧。后路手术切除寰椎后弓半距范围不超过13mm。误伤单侧椎动脉可缝扎和骨块填塞。免误伤双侧椎动脉。
Objective:To explore management strategies to avoid the intraoperative vertebral arterial trauma during the cervical spondylosis operation.Method:A total of 32 patients with vertebral arterial type of cervical spondylosis received cervical anterior approach operation,other 12 patients suffering from cervical vertebral instability received cervical posterior approach operation.The clinical results were investigated and evaluated.Result:All the patients recovered uneventfully,the excellent rates were 93.8%and 75% respectively.Unilateral vertebral artery injury occurred in two cases.There were no postoperative ischemie complications after performing hemahemostasis through ligation,tamponade of the bone covered with glutin sponge.Conclusion:The border of the safe area of anterior vertebral decompression and subtotal vertebrectomy is in uncinate process medial wall and Longus colli medial part,the width of which not more than 20cm.It is necessary for cervical anterior approach to be performed by the surgeon with good surgical technique with microsurgical instruments.The border of the safe area of posterior approach is atlas posterrior semiarch≤13mm,Unilateral vertebral artery injury can be treated by ligation or bone tamponade.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2005年第11期807-810,共4页
Orthopedic Journal of China
关键词
椎动脉
颈椎
手术
并发症
Vertebral artery
Cervical spondylosis
Operation
Complication
