C_7神经移位经背侧入路椎管外吻合腰神经前根重建截瘫下肢迈步功能的应用解剖  

Applied anatomy of C_7 nerve transfer to anastomose anteriar lumbar spinal roots outside the vertebral canal through dorsal approach to restore the low limb move function for paraplegia patients

作　　者：吕占辉[1] 王树锋 孔令贵[1] 张磊[1] 蔡长马[1] 

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

出　　处：《中国组织工程研究与临床康复》2010年第53期9987-9990,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：山东省卫生厅科技攻关项目"颈7神经移位重建截瘫下肢功能的基础与临床研究"(1999CA2BGB1)内容之一~~

摘　　要：背景:利用周围神经移位重建截瘫平面以下的肢体运动及尿便功能方面已经做了很多有意义的工作,在选择移位神经及如何重建截瘫患者迈步方面没有定论。目的:为C7神经移位经背侧入路椎管外吻合腰神经前根重建提供解剖学基础。方法:在12例成人尸体标本上,经背侧入路观测椎管外L2,L3,L4神经前根的显露、排列及可切取长度、C7神经转移路径距离及胫神经可切取长度。结果与结论:经背侧入路椎管外L2,L3,L4神经前支可辨认,L2,L3,L4神经前支的可切取长度为(1.81±0.35),(2.20±0.37),(1.45±0.31)cm;胫神经可切取长度(63.87±4.23);C7至梨状肌下孔的距离为(65.65±2.98)cm;C7至L2,3,4神经前支距离分别为(50.83±5.58),(53.15±5.82),(55.93±6.51)cm。胫神经可切取长度能够满足C7至梨状肌下孔的距离及C7至L2,L3,L4神经前支距离。结果提示,C7神经作为动力神经源,胫神经可选择为桥接神经,经背侧入路椎管外吻合L2,L3,L4神经前根重建截瘫迈步功能的具有可行性。BACKGROUND：It has made great progress in reconstructing limb motion or urination and defecation functions using peripheral nerve transfer for paraplegia patients,however,it is undefined how to select transferred nerves or restore the lower limb move function.OBJECTIVE：To provide anatomic basis for C7 nerve transfer to anastomose anterior lumbar spinal roots outside vertebral canal through dorsal approach.METHODS：The correlation and length of L2,L3,L4 anterior lumbar spinal nerves,the transfer route of C7 nerve and the length of the tibial nerve were observed in 12 adult specimens.RESULTS AND CONCLUSION：The L2,L3,L4 anterior lumbar spinal nerves could be identified and cut length were（1.81± 0.35） cm,（2.20±0.37） cm and（1.45±0.31） cm,respectively.The cut length of tibial nerve was about（63.87±4.23） cm,which was suitable for the distance of（50.83±5.58） cm,（53.15±5.82） cm,（55.93±6.51） from C7 to L2,L3,L4 anterior lumbar spinal nerves and the distance of（65.65±2.98） cm from C7 to infrapiriformis foramen,respectively.C7 nerve can be selected as transfer nerve,while the tibial nerve can be regarded as the optimum bridging nerve.It is feasible to anastomose the L2,L3,L4 anterior lumbar spinal nerves outside vertebral canal through dorsal approach.

关 键 词：背侧入路 截瘫 C7神经 腰神经前根 应用解剖 

分 类 号：R617[医药卫生—外科学]