下腰椎侧方入路中相关神经的临床解剖学研究  

Clinical anatomy study of nerves related to the lower lumbar lateral approach

作　　者：邢建强[1] 房清敏[1] 孙兆忠[1] 仲江波[1] 王大巍[1] 

机构地区：[1]滨州医学院附属医院骨科,山东滨州256603

出　　处：《中国矫形外科杂志》2011年第7期585-588,共4页Orthopedic Journal of China

基　　金：山东省医药卫生科技发展计划基金资助(基金编号:2007HZ041)

摘　　要：[目的]研究下腰椎侧方入路中相关神经的应用解剖学特点,为该手术入路提供解剖学依据。[方法]观测21具成人尸体标本L3-S1神经根前支、闭孔神经及腰交感干的走行及与周围结构的毗邻关系。[结果]L3-S1神经根前支位置及走行相对恒定;骶髂关节间隙最上缘至L4、5神经根前支外侧缘及闭孔神经外侧缘的水平距离分别为（18.96±2.59）mm、（23.29±2.48）mm、（15.49±3.01）mm;骨盆界线与骶髂关节间隙交点至腰骶干外侧缘的水平距离为（6.20±2.08）mm;骶骨岬前外侧缘到第1骶前孔上缘切线的垂直距离为（28.73±2.93）mm。[结论]下腰椎侧方神经的走行及解剖学形态具有一定规律性,在下腰椎侧方手术入路中,可有效避开或牵开这些结构,避免术中损伤。[Objective]To study anatomic characteristics of nerves and provide anatomic data for lower lumbar lateral surgical approach. [Methods]This study investigated 21 human cadavers under a microscope to record the course of anterior branch of L3～S1 nerve roots and lumbar sympathetic trunk and their relationship with surrounding structure.[Results]The location and course of anterior branch of L3~S1 nerve root were relatively constant.The horizontal range from superior border of sacroiliac joint to lateral border of anterior branch of L4、5 and obturator nerve were 18.96±2.59 mm、23.29±2.48 mm、15.49±3.01 mm.The horizontal range from the intersection point of arcuate line of pelvis and sacroiliac joint to lumbosacral trunk was 28.73±2.93mm.The vertical dimension of anterolateral border of cochlear of sacral bone to tangent line of superior border of first anterior sacral foramina was 28.73±2.93 mm.[Conclusion]The course,distribution and anatomic morphology of lateral nerves of lower lumbar spine have their own regularity.The lower lumbar lateral approach can efficiently keep clear of these anatomic structures.

关 键 词：下腰椎 侧方入路 神经 解剖学 

分 类 号：R687.3[医药卫生—骨科学]