摘要
目的 :为单纯或合并临近神经损伤的骨盆后环骨折手术提供解剖学基础。方法 :对 2 0具防腐成年尸体标本依次选取不同平面用分规和克氏针测量L4、5神经前支、腰骶干与骶髂关节间的水平距离。结果 :L5神经前支在其出椎间孔处、L4神经前支在L5椎间孔处、腰骶干在其汇合点处、腰骶干在平骶岬处、腰骶干在骨盆环处与骶髂关节间的距离分别为 :(2 3 .4± 4.0 )mm、(17.8± 4.8)mm、(13 .3± 2 .8)mm、(11.8± 3 .2 )mm、(9.6± 3 .6)mm ,其中在骨盆环处腰骶干与骶髂关节间距离最短 ;在分离神经时可见L4、5前支和腰骶干与骶骨之间有结缔组织相连 ;有 3具标本L4、5神经前支在进入小骨盆前未汇合成腰骶干。结论 :在单纯或者合并L4、5前支和腰骶干损伤的骨盆后环骨折手术中 ,由于骨盆环处腰骶干外缘与骶髂关节间距离最近 ,因此一定要小心辨认 ,勿损伤该神经。
Objective:To provide anatomical basis for the exploration and operation in fracture of posterior pelvic ring with or without the injuries of nerves nearby. Methods: 20 adult cadavers fixed with formalin were dissected and horizontal distances between anterior branches of lumbar nerves 4, 5, lumbosacral trunk(LST) and sacroiliac joint were measured with a caliper and a Kirschner wire. Results: The distance between the anterior branches of lumbar nerve 5 exiting from the intervertebral foramen and the sacroiliac joint, the distance between anterior branches of lumbar nerve 4 branch and the sacroiliac joint at the level where the lumbar nerve 5 exiting the intervertebral foramen, the distance between the beginning of the LST and the sacroiliac joint , the proximity of the LST to the sacroiliac joint at the promontorium and the proximity of the LST to the sacroiliac joint at the pelvic brim were as follows: (23.4±4.0)mm,(17.8±4.8)mm,(13.3±2.8)mm,(11.8±3.2)mm and (9.6±3.6)mm . Among these distances, the shortest distance between the nerve and the joint was the one between the LST and the sacroiliac joint at the pelvic brim. During dissection of the nerves, anterior branches of the lumbar nerves 4, 5 and the LST were found to be fixed relatively well to the sacral bone with fibrous connective tissue. Anterior branches of lumbar nerves 4, 5 did not merge into the LST before entering the lesser pelvis separately in 3 cadavers. Conclusions: During the exploration and operation for fracture of posterior pelvic ring with or without injury of nerves nearby, great care should be taken to identify the LST because the distance between the LST and the joint is the shortest.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2004年第2期148-149,共2页
Chinese Journal of Clinical Anatomy
关键词
L4、5神经前支
腰骶干
骶髂关节
骨盆后环骨折
anterior branches of lumbar nerves 4,5
lumbosacral trunk
sacroiliac joint
posterior pelvic ring fracture
