摘要
目的评价在枕颈手术中应用术前CT血管造影(CTA)技术的价值。方法16例枕颈疾病患者在术前进行CTA检查。完成3D重建后,评价椎动脉寰枢段走行、分支。测定寰椎椎动脉沟距中线距离、侧块中点距中线距离、枢椎峡部宽度等指标。根据影像学研究进行后路枕颈固定2例,后路寰枢固定10例,经口1例,经口+枕颈固定2例,单纯减压手术1例。结果影像学研究发现椎动脉不对称3例,异常分支2例,直接入颅1例,肿瘤侵犯1例。16例手术均未出现医源性椎动脉及脊髓损伤。结论在枕颈部畸形及肿瘤患者存在很高的椎动脉异常发生率,CTA是进行枕颈部手术前一项很有价值的检查,降低了损伤椎动脉的发生率。
Objective To evaluate the application of computed tomography angiography in the occipitocervical surgery. Methods Sixteen cases of occipitocervical diseases were investigated by computed tomography angiography. After 3D reconstruction, the bone structures, especially the sulcus of vertebral artery, the artery and it＇s branches, the distance between lateral mass and midline, and width of axis isthmus were studied. According to the image study, surgeries were performed including occipitocervical fixation 2 cases, posterior atlantoaxial fixation 10 cases, trans-oral ariantoaxial fixation 1 case, trans-oral combined posterior occipitocervical fixation 2 cases, and simple decompression 1 case. Results There were 3 cases existing in the asymmetry of vertebral artery, 2 with abnormal segment, 1 directly entering the foramen magnum, and 1 invaded by tumor. No iatrogenic injury of vertebral artery or spine cord developed. Conclusions There is a relative higher incidence of vercebral artery abnormity in occipitocervical deformity and tumor. Computed tomography angiography is a useful pre-surgery image before the occipitoeervieal surgery, which can decrease the morbidity of injury vertebral artery.
出处
《临床骨科杂志》
2007年第1期4-7,共4页
Journal of Clinical Orthopaedics
关键词
CT血管造影
枕颈手术
椎动脉/放射摄影术
computed tomography angiography
occipitocervical surgery
vertebral artery/radiography
