腰神经后外支卡压症针刀手术入路研究  

Operative procedure with small-needle-scalpel for the treatment of posterolateral branches entrapment syndrome of the lumbar nerve

作　　者：陈跃[1] 吴炳煌[1] 吴明霞[2] 李俐[2] 张家栋[1] 

机构地区：[1]福建中医学院,福建福州350003 [2]福建中医学院附属第二人民医院

出　　处：《中国骨伤》2001年第10期606-608,共3页China Journal of Orthopaedics and Traumatology

基　　金：1997年福建省卫生厅科研基金资助项目 (编号 :9779)

摘　　要：目的　研究腰神经后外支卡压症的解剖学机制以及针刀治疗腰神经后外支卡压症的手术入路。方法　在 15具成年尸体的腰背部解剖观测腰神经后外支及其通过的腰椎横突背骨纤维管的解剖结构 ,并进行骨纤维管的表面解剖测量。结果　测得腰神经后外支直径 1 0 7±0 17mm ;腰神经横突背骨纤维管的横径 2 13～ 3 92mm ,纵径 1 0 8～ 1 97mm ,后外支骨纤维管距体表深度 3 4 17～ 4 1 64mm ,骨纤维管长轴与后中线夹角约 4 0°～ 5 0°。结论　 ( 1)在正常情况下腰椎横突背骨纤维管有制约保护腰神经后外支的作用 ,但在损伤变形后却成为腰神经后外支卡压症主要致病因素。 ( 2 )根据解剖观测设计了较合理的针刀治疗后外支卡压症的手术入路并指出了手术中应注意避免损伤的结构 ,供临床治疗参考。Objective To explore the anatomical mechanism of posterolateral branches entrapment syndrome of the lumbar nerve and operative procedure with small needle scalpel for the treatment Methods The topical anatomy and surface anatomy of lumbar nerve posterolateral branches in the tubulus of lumbar transverse process dorsales had been observed in 15 adult specimens.Results The diameter of the lumbar nerve posterolateral branches were 1 07±0 17mm,the diameter of the bony fibrous canal over posterior aspect of the lumbar transverse process dorsals were 2 13～3 92mm on coronal section,1 08～1 97mm on sagittal section and the depth of the canal were 34 17～41 64mm,the angle between the long axis of the canal and posterior median line were 40°～50°.Conclusion The bony fibrous canal has the function of protecting and restricting the lumbar nerve posterolateral branches under normal condition,however it becomes the main factor of entrapment of the posterolateral branches of the lumbar nerve when distortion occurred following injury.(2)The rational operative procedure with small needle scalpel for the treatment of lumbar nerve posterolateral branches entrapment syndrome was mapped out according to the anatomical observations and the structures that should be protected during the procedure were also pointed out.

关 键 词：腰痛 神经压迫综合征 解剖 针刀治疗 

分 类 号：R681.55[医药卫生—骨科学]