C7神经移位椎管内吻合腰神经前根重建截瘫屈髋伸膝功能的应用解剖  

Applied anatomy of C_7 nerve transfer and anterior lumbar spinal roots anastomosis in vertebral canal to restore the lower limb function of paraplegia

作　　者：吕占辉[1] 王树锋[2] 孙今占[1] 王学丽[1] 蔡长马[1] 高鹏飞[1] 

机构地区：[1]滨州市中心医院骨科,山东滨州251700 [2]北京市积水潭医院手外科,北京100053

出　　处：《中国临床解剖学杂志》2008年第5期488-490,共3页Chinese Journal of Clinical Anatomy

基　　金：山东省卫生厅科技攻关项目(1999CA2BGB1)

摘　　要：目的:为C7神经移位椎管内吻合腰神经前根重建截瘫患者屈髋伸膝功能提供解剖学基础。方法:在20例成人尸体标本上,观测L1阶段椎管内L1～4神经前根排列及纤维数、C7神经转移路径距离及坐骨神经可切取长度及远端纤维数。结果:一侧C7神经经椎体前通路跨越椎体中线的长度为(2.4±0.58)cm,可与对侧C7神经编织成束。在L1节段,L1～4神经前支可辨认并能编织成束供吻合。胫神经和腓总神经可切取长度(52.35±2.60)cm,(48.20±2.37)cm能够满足C7至L1段椎管的距离(48.35±3.36)cm。一侧胫神经和腓总神经远端纤维数(26856±112),(25700±156)大于一侧腰L1～4神经前支纤维数(20766±354)。结论:坐骨神经可选择为颈7神经移位重建截瘫下肢功能的桥接神经,双侧C7神经可经椎体前通路编织成束作为动力神经源,在L1阶段椎管内吻合L1～4腰神经前根的具有可行性。Objective： To provide anatomic basis for C7 nerve transfer to anastomose anterior lumbar spinal nerve in vertebral canal to restore the lower limb function of paraplegia. Methods： The correlation and the number of nerve fibre of lumbar spinal nerve at the L1 level, the transfer route of C7 nerve, the length and the number of fibre of the sciatic nerve were noted on 20 adult cadaveric specimens. Results： The length of the C7 passed through the anterior side of vertebral body was about （2.4±0.58）cm, which can be anastomosed with the contralateral C7 nerve. At the level of L1, the L1-L4 anterior lumbar spinal nerves can be identified and anastomosed. Tibial and peroneal nerves can be cut about （52.35±2.60） cm and （48.20±2.37） cm respectively, which was suitable for the distance of （48.35±3.36）cm from C7 to L1. The number of fibres of the distal tibial nerve of （26856±112）, and that of the distal peroneal nerve of （25700±156） was more than that of anterior branch of L1-4 （20766±354）. Conclusions： The sciatic nerve can be regarded as the optimum bridging nerve. The double C7 nerve waved into beam through the prespinal route can be selected as transfer nerve. It is feasible to identify and anastomose the L1-L4 anterior lumbar spinal nerves at the L1 level.

关 键 词：椎管 截瘫 C7神经 腰神经前根 应用解剖 

分 类 号：R622.3[医药卫生—整形外科]