| ObjectivesAnterior microforaminotomy (AMF)is a new microsurgery technique for cervidal disorders that reported by Joh in 1996.The main thought of this procedure is relieve the symptoms of atients by removeing the uncinate processes and spur of bodies directly under the microscope, Because of applied for a short time, the anatomy relating of that procedure has not opened out clearly.especiallyer about sympathetic trunk (ST) and vertebral artery. It is unclearly about the stability of cervical spine after uncinate processes removed. And, the operation cases treated by AMF are not nough.a few questions about that procedure have not been studied clearly. The aim of this article will study about AMF with anatomic, biomechnics and clinical methods.Include: (1) To observation the morphmetric of uncinate processes and the neighboring structure ; To determine the drill entrance point ; (2) To explore the methods to aviode the injury of veterbral artery; (3)Open out the valnarability of sympathetic strunk(ST) and recurrent laryngeal nerve(RLN), and explore the methods to aviode these structure injuried; (4) Application range of motion(ROM), to explore the rationality of the AMF;(5)To explore the validity and reliability of anterior microforaminotomy; (6)To advance the operation indications of AMF.Materials and Methods1. Twenty-five formaalin marinate adult cadavers were obseraved. To observat the distance between uncinate processes and ipsilateral midale of longus colli muscle(LCM); Then, to observat the morphmetric of uncinate procrsses(UP) and relationship between other neighboring structures on dry cervical veterbrae.2. Twenty lateral positon X-ray photographies of cervical spine were mearsured. To observat the distance between the apox of inferior-5-endplant and the rim of ante-inferior of the veterbral body.3. To observe the level that veterbral artery(VA) enter the hole of transcurrent, and the diameter of VA, and relationship between VA and UP.4. To observe the variance type and diameters of ST; Mearsure the distance between the ST and the midale of LCM and anterior midline, and the anterior tuber of the transcurrent. And to observe the morphmetric and location of cervical ganglion. To observe the morphmetric of RLN and the relationship between RLN and inferior throid artery..5. Six fresh adule cervical spine were classified to 5 status, A: intact status; B: unilateral single level UP resected; C: unilateral multilevel UP resected; D: unilateral single level UP resected and associate with part bodies resected ; E: bilateral single level UP resected. The ROMs of mearsured segment were noted. With the ROMs of intact and injury sepcimens were compared each other, the stability of mearsured motion segments after various status was analyzed.6. Simulated Joh's procedure in ten adult cadavers. Observed the position of cervical nerve root in decompression hole after the uncinate processes were removed. And ,one patient who suffered from cervical spondylotic myelopathy associate with radiaculophy had been operated with AMF, and has followed up for 6mo.Results1. The distance between the rise point of anterior foot of uncinate processes and the midale of LCM, C7 is the largest and C4 is the shortest; the mean ante-posterior lengh of UP is (11. 69?.93)mm; The width fromC3 to C7 gradually increasing, the mean is (5.43 ?0.89)mm; And the height has significant difference each other, C5 is the largest (5.09?.98)mm. The distance between the apox of UP and the wall of transcurrent foramen is the shortest in C5. The mean is (1.62+ 0.62)mm.2. The distance between apox point of inferior endplant and ante-inferior rim of the bdy in lateral position cervical spine X-ray-6-photography, is the largest at C5, mean is (2.98?.89)mm.3. VA enter into transcurrent foramen at Ce mostlly. From C6 to C3, the diameter of VA is changing smaller, gradually, and left is larger than right.4. There are six variance type on ST: Main branch tye; (D Parallel branches type; Main branch and...
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