腰骶丛三角工作区的应用解剖及临床意义  

Applied anatomy and clinical significance of three-dimensional reconstruction of the lumbosacal plexus

作　　者：朱爱国[1] 陈云[2] 张烽[3] 朱建炜[3] 金国华[4] 

机构地区：[1]江苏省如东县人民医院骨科,江苏省如东县226400 [2]江苏省如东县人民医院内科,江苏省如东县226400 [3]南通大学附属医院骨科,江苏省南通市226001 [4]南通大学医学院解剖学教研室,江苏省南通市226001

出　　处：《中国组织工程研究》2016年第53期7946-7951,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:目前腰骶丛三角工作区的概念比较混乱,需要通过实体解剖探索其实际的解剖范围界定和面积来指导临床实践。目的:测量不同定义的腰骶丛三角工作区解剖范围界定和面积大小,为腰椎间盘微创技术安全性提供解剖学依据。方法:解剖20具成人尸体标本的双侧腰骶丛,显露腰神经前支、关节突与下椎体终板区域,每个椎体的双侧神经根都被解剖到远端的网状组织。测量双侧L3-S1椎体间上关节突外侧和硬膜囊外侧的三角工作区的底和高的长度,并计算三角工作区的面积。结果与结论:(1)L3-S1椎体间上关节突外侧三角工作区的面积男性介于23.8-30.7 mm^2,女性介于18.7-27.3 mm^2;硬膜囊外侧三角工作区面积男性介于92.4-103.7 mm^2,女性介于87.5-102.7 mm^2;(2)结果说明,L3-S1椎体间上关节突外侧三角工作区的面积介于18.7-30.7 mm^2,硬膜囊外侧三角工作区面积介于87.5-103.7 mm^2,在此三角工作区内进行手术操作是安全的。BACKGROUND： Conception of three-dimensional reconstruction of the lumbosacal plexus is confused, and actual physical anatomy is needed to confirm its range and area thus providing guidence for clinical pratice. OBJECTIVE： To measu the range and area of three-dimensional reconstruction of the lumbosacal plexus using different definitions, thereby providing anatomical basis for minimally invasive technique of lumbar disc. METHODS： Posterior dissections of the lumbosacral plexus were performed bilaterally on 20 embalmed adult cadavers. Particular attention was paid to dissect anterior branches of lumbar nerve, upper articular process and lower vertebrae. Bilateral nerve roots at each spinal level were identified, and dissected distally to expose the plexus. The length of bottom and height of three-dimensional reconstruction locating on the lateral upper articular process between L3-S1 and the lateral of dural sac were measured to calculate the area.RESULTS AND CONCLUSION：（1） The area of three-dimensional reconstruction locating on the lateral upper articular process between L3-S1 ranged from 23.8 mm-2 to 30.7 mm-2 in males, and 18.7 mm-2 to 27.3 mm-2, respectively. The area of three-dimensional resconstruction locating on the lateral dural sac ranged from 92.4mm-2 to 103.7 mm-2, and 87.5 mm-2 to 102.7mm-2, respectively.（2） In conclusion, the area of three-dimensional reconstruction locating on the lateral upper articular process between L3-S1 and dural sac covers from 18.7 mm-2 to 30.7 mm-2, and from 87.5 to 103.7 mm-2, respectively, so operating in this triangle is safe.

关 键 词：腰骶丛 解剖 椎间盘 组织工程 骨科植入物 脊柱植入物 后入路 三角工作区 应用解剖 

分 类 号：R318[医药卫生—生物医学工程]