Sectional anatomy study of the clivus regoin and its three dimensional reconstruction / 局解手术学杂志

Objective To study the anatomical characteristics of sectional clivus region and to provide anatomical data for the operation of the clivus regoin.Methods Continuous thin sections(transverse position and coronal position)from two head specimens were performed with freezing milling technique.Observed the anatomical relationship and anatomical characteristics of the clivus region,and finished the three dimensional reconstruction based on the data of sections.Results Totally obtained 320 transverse sections and 232 coronary sections.The related structures were described in 4 typical sections,and three dimensional reconstruction of the clivus region were produced.Conclusion Combinationof section anatomy and three dimensional reconstruction can stereoscopically display the anatomical characters of the clivus re -gion.The three dimensional models could continuously and dynamically display the anatomic structures.

Anatomical relationship of the internal jugular vein and the common carotid artery in Korean : A computed tomographic evaluation

BACKGROUND: It is important to understand the anatomical relationship of the internal jugular vein (IJV) to the common carotid arteries (CCAs) to avoid inadvertent arterial injury. This study used computed tomography (CT) to evaluate this relationship and the changes associated with simulated 30o body rotation (SR30) in Korean subjects. METHODS: A retrospective analysis of 81 healthy adult subjects was performed using CT during physical checkups between November 2012 and September 2013. Data on both the left and right side IJV and CCA were recorded at the level of the cricoid cartilage and analyzed. The CCA was used as a reference for estimating the IJV location; this was recorded as lateral, anterior, medial, or posterior, using a segmented grid. The degree of overlap was calculated as a percentage, and changes to the anatomic relationship and overlap percentage caused by SR30 were derived. RESULTS: Prior to simulating rotation, the IJV was lateral (54.3%), posterolateral (27.2%), anterolateral (17.9%), or anterior (0.6%) to the CCA. After SR30, their position moved significantly in the anterolateral direction (P = 0.000). The degree of overlap significantly increased from 42.0 to 91.4% after SR30 (P = 0.000). No significant difference was observed between results obtained on the right and left sides before or after SR30. CONCLUSIONS: Special attention should be paid to possible CCA puncture during IJV catheterization because head or body rotation may induce anterior shifting of the IJV location relative to the CCA as well as an increased degree of overlap.

Analysis of Aortic Passage in the Thoracic Region by Magnetic Resonance Imaging / 대한척추외과학회지

STUDY DESIGN: The relationships between aorta and thoracic vertebrae were analyzed by using MR images. OBJECTIVES: The purpose of this study was to provide information upon the thoracic aortic passage to prevent vascular compli-cations during anterior and posterior instrumentations for various spinal disorders and traumas. SUMMARY OF BACKGROUND DATA: A number of morphometric investigations have been performed on the thoracic vertebrae, but the anatomical relationship between aorta and the thoracic vertebral body has not been analyzed. METHODS: The MR images of 32 patients with normal thoracic vertebral column were obtained. The angle between the transverse axis of the thoracic vertebral body and the thoracic aorta, the diameter of the thoracic aorta and the closest distance between the thoracic vertebral body and the thoracic aorta from T2 to T12 were measured on axial MR images. RESULTS: The smallest angle between the transverse axis of the thoracic vertebral body and the line connecting the centers of the vertebral body and aorta was 6.8 degrees/3.7 degrees(male/female) in the T5-6 region and highest angle observed was 56.3 degrees/55 degrees in the T12 region. The angle decreased between T2 and T5-6 and then increased after T6. The mean external diameter of the thoracic aorta was 32.8 mm, and the largest diameter of the thoracic aorta was 24.7/25.4 mm (M/F) in the T4-5 region. The aortic arch was first seen in the T2 region and it formed an arch in the T3-4 region. The shortest distance between the thoracic vertebral body and the thoracic aorta wall was 0.8/0.7 mm in the T12 region and the greatest distance between the vertebral body and the aorta was 11.84/6.75 mm in the T2-3 region. CONCLUSION: From T4 to T8, the aorta is located just left lateral to the vertebral body. In this area, the aorta is jeopardized by a screw penetrating the vertebral body during anterior instrumentation, if the screw protrudes beyond the pedicle during posterior instrumentation. The surgeon should be familiar with the anatomical relationship between aorta and the vertebral column when planning a surgical procedure or the use of instrumentation in this region.