腰骶部脊神经后根应用解剖学研究  

Applied anatomical study of lumbar and sacral posterior nerve root

作　　者：高晓群[1] 王延芬 聂培力[2] 高龙远[2] 

机构地区：[1]河南医科大学脑瘫外科研究治疗中心,郑州450052 [2]新疆石河子大学医学院解剖学教研室,石河子832002

出　　处：《河南医科大学学报》1999年第2期17-20,共4页Journal of Henan Medical University

基　　金：河南省卫生科研基金!901047003

摘　　要：为了解腰骶部脊神经后根形态及周围结构在脑瘫肌痉挛手术治疗中的价值。方法：用手术显微 镜解剖观测童尸标本４０具、成尸标本６０具腰骶部脊神经后根及其周围结构。结果：儿童自然后根丝为４－６束，成 人为８～１２束，集成２个干，形成后根到达硬脊膜初级孔，分为硬脊膜内侧段、硬脊膜外腔段、脊神经节段、脊神经外 侧段４段。硬脊膜内侧段长度儿童为４～１５ ｃｍ，成人为６～２０ ｃｍ。腰２～５和骶 １腰骶脊神经后根穿硬脊膜裂孔处 直径，儿童平均值为１.３ ｍｍ、１．４ ｍｍ、２．０ ｍｍ、２．２ ｍｍ、１．７ ｍｍ；成人平均值为 ２．０ ｍｍ、２．２ ｍｍ、２．４ ｍｍ、２．７ ｍｍ、 ２．２ｍｍ。棘突根部下缘与椎板下缘交点是两侧脊神经后根穿椎间孔处连线的对应点。结论：棘突根部下缘可作为 寻找同序数脊神经后根的标志；保留腰２、４和骶１椎板及腰４脊神经后根完整性的改良选择性脊神经后根切断术 治疗脑瘫下肢痉挛可行。Aim:To understand the value of lumbar and secral posterior nerve root and its surrounding structure in the surgical treatment of crerbral palsy spasm.Methods:The lumbar and sacral posterior nerve root and their surrounding structures wrer examined with operative microscopy in 40 child cadavers and 60 adult cadavers.Result:The posterior nerve root consisted of 4~6 cords in children and 8~12 cords in adults.These cords formed of 2 trunks down to the first foramen of spinal dural dura.They were divided into four segments:Spinal dural interior segment,spinal dural exterior lumen segment,spinal ganglion segment,and spinal exterior nerve segment.The length of the spinal dural interior segment was 4~5cm in children,and 6~20 cm in adults,The exterual diamater of the lumber,sacral posterior spinal nerve root at the foramen of the spinal dura:the average values from lumbar 2~5 to sacral 1 for children were 1.3mm,1.4mm,2.0mm,2.2mm,and 1.7mm respectively for adults were 2.0mm,2.2mm,2.4mm,2.7mm and 2.2mm respectively.Inferior margn of the spinal process root can be regarded so a landmark to find the posterior spinal nerve root of the same ordinal number.We only showed lumbar 2,3and 5 sacrall posterior roots and partly removed lumbar 2,3,5and sacral 1 postorior root.Conclusion:The selective posterior rhizotomy and completely remainingof lumbar laminal 2 and 4,sacral laminal 1,and lumbar 4 posterior roots is suceessful.

关 键 词：腰骶脊神经后根 应用解剖学 痉挛性脑瘫 

分 类 号：R322.85[医药卫生—人体解剖和组织胚胎学]