Clinical Application And Homologic Anatomy Study On Anterior Operative Approach To Cervicothoracic Vertebral

Aim To discuss the clinical application and the homologic anatomy of anterior operative approach to cervicothoracic vertebral.Methord The clinical manifestation,auxiliary examination and operation method of 16 cases undergoing by anterior operative approach to cervicothoracic vertebral from 2005 are retrospective analyzed.Results 11 cases of the 16 cases were sufficient followed up,and the average follow-up time was 7.8 months.The chief items were functional assessment of the spinal cord and the recovery of the complication.Accord to JOA grade method,the clinical outcome was graded as excellent in 7cases,good in 2 cases,effective in 1 case,and ineffective in 1 case.The symptomof hoarse voice in one case disappeared after 3 mionths.There was no injury of alimentary duct in the 16 cases,so there was no follow-up results.Homer symptom complex was not found in the 11 cases.Conclusion According to JOA grade method,postoperative scores and preoperative scores were compared and it showed the statistical significance.It is effective to improve the symptoms of nerve injury by anterior operative approach to cervicothoracic vertebral,but complications of operative procedure also follow sometimes.So it is important to master the knowledge of homologic anatomy to avoid the commitments.Injury of recurrent laryngeal nerve happened sometimes in the operation.The right recurrent aryngeal nerve goes to laryngeal nerve,recurrent groove at the level of T1,so it should be paid more attention in the operation at the lenel of T1 or T2.So it is suitable to choose the left interspace.The alimentary duct goes beside the internal surface of left subclavian artery at the level of T1 o T2,and this can be used for looking for the alimentary duct.Homer symptom complex was not rare in the operation.Truncus sympathicus cervicalis is closest to the medial border of collilongus at the level of C6 and C7,and it is easy to injury the truncus sympathicus cervicalis.It is necessary to take the phlebography and the CTA before operation.