目的 为经后正中入路切除颅颈交界区病变提供手术解剖学资料；探讨各种不同颅颈交界区病变的临床特征、手术注意事项及其临床应用.方法 对10例成人甲醛固定的头颅标本进行了经后正中入路解剖观察及相关数据的测量.同时回顾性分析30例延颈髓肿瘤的病理类型、临床表现、辅助检查、手术切除程度及临床疗效.结果 颅颈交界区包括众多的肌肉、血管、神经结构,他们的关系复杂；椎动脉在该区行程曲折.30例延颈交界区病变中全切除29例(96.7％),1例黑色素转移瘤近全切除,无手术死亡,全组病例临床表现均得到改善.结论 通过尸头实验,经后正中入路对颅颈交界区进行显微解剖、观察、测量和拍照,为手术处理该区病变提供翔实的显微解剖学资料.%Objective To study microsurgical anatomy of the lesions of craniovertibral junction area dissected from post-median direction,discuss the clinical features of lesions in different craniovertibral junction area and attention and clinical application in operation.Methods Ten adult cadaveric head specimens were dissected by using microsurgical anatomic skills,and observation and measurement were performed on related anatomic structures of craniocervical junction region.In thirty case of medulla oblongata and intramedullary spinal cord tumors,the tumor histological types,clinical manifestations,adjuvant examinations,the extent of tumor resection and operative outcome were analyzed retrospectively.Results There were many important anatomic structures related to this region,and their ubiety was complicated.The vertebral artery ran a tortuous course in this region.Twenty-nine of thirty tumors were totally resected(96.7％),one case of metastasis from melanoma was subtotally resected,there was no operative mortality,clinical manifestation of all cases improved.Conclusion The results of observation and measurement are helpful for identifying and protecting vital structures during surgery related to the craniocervical junction region.
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