腰椎椎弓根与其毗邻神经关系的临床解剖观察  

Clinical Anatomy Observation of Anatomic Relations between the Lumbar Pedicle and the Adjacent Neural Structure

作　　者：欧阳晓[1] 王景荣[1] 王培先[1] 王林[1] 周勇[1] 

机构地区：[1]江苏大学附属徐州医院暨徐州市第三人民医院骨科,江苏徐州221005

出　　处：《实用骨科杂志》2008年第3期152-155,共4页Journal of Practical Orthopaedics

基　　金：徐州市卫生科研项目(XW2005016)

摘　　要：目的对腰椎弓根与其毗邻神经结构的关系进行临床解剖学观察,以明确腰椎椎弓根与其毗邻神经的解剖关系和解剖数据。方法40例成人防腐尸体标本,男20例,女20例,进行解剖学观察,测量腰椎弓根上缘至且上位神经根下缘的最小距离(the distance from the pedicle to the adjacent nerve roots superiorly,DS)、腰椎弓根下缘至下位神经根上缘的最小距离(the distance from the pedicle to the adjacent nerve roots inferiorly,DI)、腰椎弓根外缘至外位神经根(上位神经根向外的延续部分)内缘的最小距离(the distance from the pedicle to the adjacent nerve roots lateral,DL)、腰椎弓根内缘至硬膜囊外缘或内侧神经结构的最小距离(the distance from the pedicle to the duralsac medially or neural structure inside,DM)。结果腰椎弓根与其毗邻神经关系的解剖数据,采用SPSS12.0统计软件进行统计学处理。左右腰椎弓根DS、DI、DL、DM无侧别差异;男性腰椎弓根DS、DI、DL、DM均大于女性;男性及女性DS>DL>DI>DM。结论腰椎椎弓根螺钉植入时,椎弓根的内侧区和下侧区毗邻神经结构相较外侧区和上侧区损伤可能性相对更大,植入螺钉时应遵循"宁外勿内,宁上勿下"的原则。Objective The purpose of the study was to determine quantitatively the anatomic relations between the lumbar pedicle and the adjacent neural structures and to analyze anatomic parameters between the lumbar pedicles and the dural sac as well as the spinal nerve roots. Methods Forty embalmed cadavers （twenty male ,twenty female） were used for this study of the lumbar spine. Anatomic evaluation of the relation of the lumbar pedicle to adjacent neural structures included the distances from the pedicle to the adjacent nerve roots superiorly （DS）,the distances from the pedicle to the adjacent nerve roots inferiorly（DI）,the distance from the pedicle to the adjacent nerve roots lateral（DL） and the distance from the pedicle to the dural sac medially or neural structure inside（DM）. All symmetric structures were measured bilaterally. Results Each parameter measured were recorded and calculated with SPSS12.0 by computer. There was no significant difference between left and right for DS,DI,DL and DM. The average distances from the lumbar pedicle to the adjacent neural structures for male were much more than the distances for female. There were common rules of anatomic relations between the lumbar pedicle and the adjacent neural structures for male or female,DS〉DL〉DI〉DM. Conclusion The lumbar adjacent neural structures medially and inferiorly were injured easilier than the structures superiorly and lateral. Improper placement of the pedicle screw medially in the lumbar spine should be avoided and proper placement superiorly and lateral should be followed.

关 键 词：解剖 尸体 腰椎弓根 椎弓根固定 神经 

分 类 号：R323.43[医药卫生—人体解剖和组织胚胎学]