骶直肠筋膜在轴向腰椎椎间融合术中的应用解剖  

Applied anatomy of the rectosacral fasia for axial lumbar interbody fusion

作　　者：王江栓[1] 丁冉[2] 赵庆豪[2] 王丰刚[1] 王建中[1] 丁自海[2] 王福青[1] 

机构地区：[1]漯河医学高等专科学校,河南漯河462000 [2]南方医科大学人体解剖学教研室,广州510515

出　　处：《中国临床解剖学杂志》2016年第3期260-262,共3页Chinese Journal of Clinical Anatomy

基　　金：国家自然科学基金(31271286);漯河市2014年度青年拔尖人才支持项目

摘　　要：目的观察骶直肠筋膜在轴向腰骶椎椎间融合术中的应用解剖。方法 10具(20侧)男女骨盆标本,观察骶直肠筋膜的位置,并进行相关解剖学测量。结果 (1)骶直肠筋膜起自S3者较多,为44.4%,将骶前间隙分为上下两部分;(2)男性骶直肠筋膜跨越直肠两侧连于骨盆腔壁腹膜,女性的则两侧跨越直肠后连于直肠子宫襞;(3)骶直肠筋膜长度(23.14±1.41)mm、厚度(1.25±0.13)mm,距离手术切口(66.10±7.03)mm、距离S1/S2横线中点(23.09±1.87)mm。结论 (1)骶直肠筋膜在骶前间隙内普遍存在,术中应对其进行锐性分离以避免骶前静脉丛撕裂伤;(2)女性骶直肠筋膜可能为子宫骶韧带的一部分。Objective To observe the applied anatomy of the rectosacral fasia （RSF） for axial lumbar interbody fusion（Axial LIF）. Methods The pelvic region of 10 human specimens were divided into 20 halves in the median sagittal plane. Related anatomical data of the RSF were collected from all specimens. Results （1） The RSF mostly originated from the level of the S2 in 44,4% which divided the presacral space into superior and inferior portions. （2） The RSF of men were across both sides of the rectum and connected to the parietal peritoneum of the pelvic, and the RSF of women were connected to the rectouterine fold. （3） The average length of the RSF was （23.14± 1.41） mm, the average thickness was （1.25±0.13） mm, the average distance to surgical incision （66.10±7.03） mm, the average distance to the midpoint of S1/S2 cable（23.09± 1.87） mm. Conclusion （1） The RSF existed universally in the presacral space which should be dissected sharply in surgery to avoid the injury to the presacral venous plexus. （2）The RSF of women may be a part of the uterosacral ligament.

关 键 词：轴向腰椎椎间融合术 骶直肠筋膜 骶前静脉丛 子宫骶韧带 

分 类 号：R323.4[医药卫生—人体解剖和组织胚胎学]