The microanatomy study of the V3 segment of the vertebral artery by different suboccipital approaches
Objective To explore the anatomical landmarks of the V3 segment of the vertebral artery and the preservation strategies in the suboccipital approach.Methods Ten adult cadaveric head specimens(20 sides)were fixed with 10％formaldehyde.The occipital muscles were dissected layer by layer from superficial to deep,the suboccipital triangle was located,and the venous plexus around the vertebral artery was removed to expose and observe the V3 segment of the vertebral artery.Then,the structures adjacent to the V3 segment of the vertebral artery were observed from the axial direction via the posterior suboccipital midline approach,the suboccipital retrosigmoid approach,and the extreme-lateral transjugular process approach.The distance between key bony landmarks of each approach and the vertebral artery was measured,respectively.Results The V3 segment of the vertebral artery was wrapped by the muscles of the suboccipital triangle and the venous plexus around the vertebral artery.The length of the V3 segment was 19.7±2.7 mm,with an outer diameter of 5.4±1.3 mm.The distance from the posterior tubercle of the atlas to the medial edge of the V3 segment was 19.1±4.1 mm in the posterior suboccipital midline approach.The vertical distance from the horizontal part of the occipital scale to the upper edge of the V3 segment was 8.7±2.6 mm,which was similar to that from the condylar fossa to the upper edge of the V3 segment(8.7±2.5 mm)in the suboccipital retrosigmoid approach.The straight-line distance from the posterior edge of the jugular foramen to the lateral edge of the V3 segment was 10.4±1.7 mm in the extreme-lateral transjugular process approach.Conclusion Familiarity with the microanatomy of the vertebral artery V3 segment and its distances from surrounding landmarks can provide reference for identifying the vertebral artery V3 segment during surgery,reducing the risk of injury to the vertebral artery,and improving the safety of surgery in the occipital region.
Vertebral arteryAutopsyMicromanipulationApproachSuboccipital region
NETL
NSTL
万方数据
