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目的研究颈椎硬脊膜后方膜椎韧带的解剖学特征,探讨其临床意义。方法内窥镜下观测13具成人防腐标本颈椎硬脊膜后方膜椎韧带的形态学特点,随后打开椎管,肉眼及手术显微镜下对膜椎韧带进行观测,记录其起止点、走行方向。用游标卡尺测量膜椎韧带的长度、宽度、厚度或直径。对膜椎韧带进行HE染色、Masson三色法染色,观察其组织形态结构特点。结果 13例颈椎标本中硬脊膜后方均有膜椎韧带出现,膜椎韧带将硬脊膜向后连于椎板或黄韧带。膜椎韧带与黄韧带连接较紧密且数量居多,占72.4%。膜椎韧带在C1/2、C4/5黄韧带出现率为100%,C1/2黄韧带处膜椎韧带厚度最大,为(1.04±0.61)cm(0.3~2.01 cm)。膜椎韧带多呈前上后下走行。根据形态特点可将膜椎韧带分4型:条带型、条索型、网格型、薄片型。光镜下观察膜椎韧带由大量密集排列的胶原纤维构成。结论颈椎硬脊膜背部膜椎韧带是将硬脊膜连于椎管后壁的正常结构,其两端分别与硬脊膜背侧及椎管后壁尤其是黄韧带连接紧密,膜椎韧带可牵拉固定硬脊膜,从而维持脊髓在椎管中的相对位置。另外膜椎韧带可能是颈椎后路手术中硬脊膜撕裂及硬脊膜外出血的解剖学因素,建议相关手术中先予辨认并切断。
Objective To study the anatomic features of the posterior lamina of the cervical spinal dural ligament and to explore its clinical significance. Methods The morphological characteristics of 13 adult posterior cervical spinal dural ligaments were observed under endoscope. The spinal canal was opened and the ligamentous ligament was observed under the naked eye and under the operating microscope. The starting and ending points and the direction of travel were recorded. Measure the length, width, thickness, or diameter of the lamina ligament using a vernier caliper. Membrane ligament HE staining, Masson trichrome staining, observed the morphological features of the organization. Results In 13 cases of cervical spine, posterior membrane ligament appeared in both posterior commissure, ligament lacrimal ligament back to the lamina or ligamentum flavum. Ligamentus ligamentum ligamentum ligamentis more closely and the number, accounting for 72.4%. The incidence of membranous ligament in the C1 / 2 and C4 / 5 yellow ligaments was 100%, and the largest in the C1 / 2 yellow ligament was (1.04 ± 0.61) cm (0.3-2.01 cm). Myelofibular ligament mostly showed before and after walking. According to the morphological characteristics of the membrane ligament can be divided into 4 types: strip type, cable type, grid type, slice type. Light microscopic observation of lamina ligament by a large number of dense arrangement of collagen fibers. Conclusions The posterior cervical spinal dural ligament is the normal structure of the spinal dura attached to the posterior wall of the spinal canal. The two ends of the ligament are connected with the dorsal spinal cord and the posterior wall of the spinal canal, especially the ligamentum flavum, respectively. Stretch the dura traction, thus maintaining the relative position of the spinal cord in the spinal canal. In addition to the posterior cervical spine ligament surgery may be dural tear and epidural hemorrhage anatomical factors, it is recommended to identify the relevant surgery and cut off.