骶骨前孔区应用解剖学研究  

Applied anatomy of presacral foramen region

作　　者：刘永刚[1] 白靖平[2] 锡林宝勒日 田征[2] 何祖胜[1] 田永让[3] 聂培力[3] 

机构地区：[1]新疆医科大学第二附属医院骨科,乌鲁木齐830028 [2]新疆医科大学第一附属医院骨科,乌鲁木齐830054 [3]石河子大学医学院解剖学教研室,石河子832000

出　　处：《中国临床解剖学杂志》2004年第2期143-147,共5页Chinese Journal of Clinical Anatomy

摘　　要：目的 :为后路骶神经管扩大减压术提供解剖学资料。方法 :对 2 6具 (5 2侧 )成人尸体进行骶前孔区血管、神经走行特点的观察 ,对具有临床意义的数据进行解剖学测量。结果 :①骶外侧动脉的分支进入骶前孔 ,S1多在骶前孔外上缘 (5 6.3 %) ,S2 多在骶前孔内上缘 (73 .1%) ;②臀上动脉与骶丛相交点水平线上距S1AB线 (横线与骶前孔内侧缘交点的垂线 ) (3 0 .0± 7.3 )mm ,S1水平线下方 (-11.3± 9.9)mm ;③骶外侧静脉与臀上静脉及出骶前孔的静脉存在吻合支 ,骶前静脉丛与椎体静脉有广泛吻合 ;④S1、S2 、S3 、S4神经与AB线的夹角分别为 (63 .1± 11.7)° ,(71.2± 11.8)° ,(70 .2± 11.3 )° ,(79.7± 16.2 )° ;⑤梨状肌多起自S2～ 4椎体侧方 ,梨状肌上缘与S1、S2 的垂直距离为 (-11.5± 11.0 )mm ,(12 .7± 10 .0 )mm。S1神经与梨状肌上缘相交点与S1的距离为 (2 2 .9± 9.8)mm。结论 :后路骶神经管扩大减压术是相对安全的 ,但应避免损伤骶前孔区的血管 ;后路骶神经管扩大减压术最好沿骶神经走行方向进行 ,到达梨状肌上缘即可。Objective: To provide anatomical data for posterior approach enlargement of sacral nerve canal, the present study was carried out. Methods: The blood vessels,sacral nerve of presacral region and piriformis were observed and measured on 26 adult cadaveric specimens. Results: ① Lateral sacral artery usually has two branches and its branches enters the anterior sacral foramen. ② The point of superior gluteal artery go through sacral plexus is (30.0±7.3)mm lateral to the AB line, (-11.3±9.9)mm inferior to the S_1. ③ Lateral sacral vein anastomoses with superior gluteal vein. The presacral veniplex has wide souse and is full of anastomosis. ④ The angle of S_1, S_2,S_3,S_4 lateral to AB line are (63.1±11.7)°, (71.2±11.8)°, (70.2±11.3)°and (79.7±16.2)° respectively. ⑤ The superior edge of piriformis are (-11.5±11.0)mm and (12.7±10.0)mm to S_1、S_2 on AB line. The distance between the point that S_1 nerve crossing the superior edge of piriformis and S_1 is (22.9±9.8)mm. Conclusions: Posterior approach enlargement of sacral nerve canal is relative safty, and should avoid injury the presacral vessels. The operation should preferably go flowing the angle of sacral nerve and stop when it met the piriformis.

关 键 词：骶孔 骶前血管 骶丛 梨状肌 应用解剖 

分 类 号：R323.46[医药卫生—人体解剖和组织胚胎学] R683.3[医药卫生—基础医学]