■在远外侧和乙状窦后入路中,椎动脉的第三段(V3)易损。虽然枕下三角(SOT)是一个有用的解剖标志,V3和形成三角形的肌肉之间的关系没有得到很好的描述。我们旨在证明V3和周围肌肉之间的关系,和SOT在临床病例中。
■检查了通过远外侧入路接受枕动脉-PICA旁路术治疗的椎动脉(VA)和小脑后下动脉(PICA)动脉瘤患者的手术视频。对2015年1月至2021年10月的视频进行了回顾性审查,以确定V3和SOT的解剖结构。
■本研究包括14名患者。使用双极切割技术在所有患者中均鉴定了同侧V3,没有受伤。水平V3段的横向68.2%,包括V3凸起,被上斜肌(SO)的下内侧覆盖。内侧23.9%被直肌炎后主要肌肉的下外侧部分覆盖。水平V3段的下中部位于SOT内。
■大部分V3,包括V3凸起,位于SO下方,V3的下部位于SOT内。应使用双极切割技术仔细进行SO的提升,以避免损伤V3。据我们所知,这是在临床环境中V3相对于SOT的首次描述。
UNASSIGNED: The third segment of the vertebral artery (V3) is vulnerable during far lateral and retrosigmoid approaches. Although the suboccipital triangle (SOT) is a useful anatomical landmark, the relationship between V3 and the muscles forming the triangle is not well-described. We aimed to demonstrate the relationship between the V3, surrounding muscles, and SOT in clinical cases.
UNASSIGNED: Operative videos of patients with the vertebral artery (VA) and posterior inferior cerebellar artery (PICA) aneurysms treated with occipital artery-PICA bypass through the far lateral approach were examined. Videos from January 2015 to October 2021 were retrospectively reviewed to determine anatomy of the V3 and the SOT.
UNASSIGNED: Fourteen patients were included in this study. The ipsilateral V3 was identified without injury in all patients using the bipolar cutting technique. The lateral 68.2% of the horizontal V3 segment, including the V3 bulge, was covered by the inferomedial part of the superior oblique muscle (SO). The medial 23.9% was covered by the inferolateral part of the rectus capitis posterior major muscle. The inferomedial part of the horizontal V3 segment is located within the SOT.
UNASSIGNED: Most of the V3, including the V3 bulge, were located beneath the SO and the inferomedial part of V3 located within the SOT. Elevation of the SO should be performed carefully using the bipolar cutting technique to avoid injury to the V3. To the best of our knowledge, this is the first description of the V3 relative to the SOT in the clinical setting.