【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。更多还原

【Abstract】 [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.更多还原