后路寰樞椎關節間撐開復位融合技術｜保護C2神經根

送玫瑰的手 2025-07-11 發布于湖北

展開全文

寰樞椎融合手術術中C2神經根的保護很重要。

C2神經根若卡壓或受損刺激常引起枕神經痛，嚴重影響患者生活質量。

如果切斷C2神經根，導致枕部感覺缺失，易導致脫發、皮膚潰瘍、甚至感染。

景椎：寰樞術后脫發、頭皮潰爛

顯露C1/2側塊關節

關節從C2的椎板和椎管內側壁往上顯露更合適，并且C2神經根應該向頭側扒開。

C1螺釘

C1螺釘偏頭側，C2螺釘偏尾側，之間留足夠空間，避免螺紋或釘尾騷擾C2神經根。

偏頭側的Tan法的軌跡更接近C1椎弓根螺釘。

粗大的C2神經根

關節處理

側塊關節的處理要先于螺釘的置入。整個處理過程中主要保護C2神經根，特別是cage的植入小心卡壓神經根（因為顯露、出血影響視野、軟組織等原因，在最后植入cage時很難做到干干凈凈的空間，所以很容易帶入部分軟組織甚至C2神經根進入關節間隙）。

參考文獻

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