Applied Anatomy And Safe Range Analysis Of P-PECD In The Treatment Of C5/6 Segment-nerve Root Cervical Spondylosis

Objective:By simulating line posterior percutaneous endoscopic cervical discectomy(P-PECD)surgical approach for C5/6 segment basic anatomy study,find a fixed anatomic landmark,study its relationship with the peripheral important organization structure,analysis a relatively safe,to guide the operation in the operation,provide reference for clinical surgery safety operation,reducing the occurrence of intraoperative complications associated;Methods:chooses 5 specimens of adult corpse,simulated clinical percutaneous cervical posterior endoscopic excision of nucleus pulposus treatment of C5/6 segments of surgical approach on cervical spondylosis of nerve root type,specification in puncture,and the puncture and catheter into the road of local anatomy,local anatomical observation group,fully exposed to the C5/6 segment vertebral plate,articular process,find the point Q(lower vertebral articular process and the lamina transitional form of intersection),respectively by the five bodies,a total of 10 specimens of C5/clearance anatomy study section 6,with fine needle retention C5/6 segment the location of the point Q,drill grinding in addition to the surrounding bone,Vertebral wrench,to deal with bone rongeur,treatment,retained needle first lateral articular process up and down,side piece of bone,convenient measurement of C5/6 segment and articular process of width and thickness of f g,then fully exposed the neck 5/6 segmental cervical nerve root,vertebral artery,dural sac,finally cut the spinal cord and complete removal,longitudinal ligament after resection in the rear of the C5,C6,to expose the neck 5 6 vertebral body,neck,cervical intervertebral disc 5/6 plane,with a sharp knife,reamer,get rid of the intervertebral disc nucleus pulposus clamp,to expose the neck 6 ditch,Using vernier calipers measurement precision(0.02 mm)C5/6 segment point Q to the structure of the shortest distance:point Q to the nerve roots of vertical distance:a;Q point to the vertical distance of vertebral artery:b;Q points to the outside of the dural sac vertical distance:c;Q to C5/6 segments in the plane of the intervertebral disc distance:d;Q point to C6 vertebral groove:e;because of the different segments intervertebral disc with corresponding segmental nerve roots are different plane,we also need to observe point Q to C5/6 segments intervertebral disc relationship with C6 nerve roots of the orbit,statistical analysis of test data,draw a relatively safe scope;Results:The vertical distance from point Q to the nerve root was a:(5.06±1.14)mm,the vertical distance from point Q to the vertebral artery b:(4.48±0.69)mm,the vertical distance from point Q to the lateral side of the dural sac was c:(12.54±0.99)mm,the distance from point Q to the intervertebral disc plane of c5/6 segment d:(10.22±0.83)mm,the distance from point Q to the furrow process of C6 vertebral body e:(7.52±0.83)mm,and the width of the upper and lower articular processes of c5/6 segment f:(13.61±1.59)mm.The thickness of the upper and lower articular processes of the c5/6 segment passing the Q point was g:(6.95±0.70)mm.Conclusion:Point Q is a marker that can be identified under endoscope during p-pecd.The relative safety range obtained by taking point Q as a marker is of certain reference significance for safe operation during p-pecd.