国人腰椎管外骨纤维管与脊神经的关系 Ⅱ.腰神经后支及其分支的解剖观察及临床意义

THE RELATION BETWEEN THE OSTEO-FIBROUS CANAL OUTSIDE OF THE LUMBAR SPINAL CANAL AND THE SPINAL NERVE PASSING THROUGH IT Ⅱ.THE STUDY OF THE POSTERIOR RAMUS AND ITS DIVISIONS OF LUMBAR SPINAL NERVE IN SPECIAL REFERENCE TO ITS CLINICAL SIGNIFICANCE

本文对中国成年人尸体40具(80侧)进行了腰神经后内侧支伴同血管经过后内侧支骨纤维管以及与腰神经后外侧支之间吻合情况的观察;测量了腰神经后支的长度、直径以及腰神经后外侧支、后内侧支的直径;同时还测量了腰神经后支分后内、后外侧支与横突根上缘间的距离。作者根据上述观察和测量提出腰神经后支及其分支有三处最易遭受卡压;一是神经出腰神经后支骨纤维管外口处;二是神经进入腰神经后内侧支骨纤维管入口处;三是神经行于腰神经后内侧支骨纤维管内骨嵴的顶坡处。并且还阐明了椎管外骨纤维管的解剖与神经之间的关系。

The posterior ramus and its divisions of lumbar spinal nerve were observed and measured in 40 adult cadavers.1.The average length of the posterior ramus of the lumbar nerve in both sexes are:L_(1)5.18 mm,L_(2)5.61 mm,L_(3)5.55 mm,L_(4)5.47 mm,L_(5)6.03 mm.The average diameter of the posterior ramus of the lumbar nerve in both sexes are:L_(1)1.51 mm,L_(2)1.53 mm,L_(3)1.42 mm,L_(4)1.23 mm,L_(5)0.77 mm.2.The average diameter of the lateral division of posterior ramus of the lumbar nerve in both sexes are:L_(1)1.31 mm,L_(2)1.29 mm,L_(3)1.18 mm,L_(4)1.02 mm,L_(5)0.54 mm.The average diameters of the medial division of posterior ramus of lumbar nerves in both sexes are:L_(1)0.75 mm,L_(2)0.80 mm,L_(3)0.73 mm,L_(4)0.70 mm,L_(5)0.25 mm.3.The distance between the point of division into medial and lateral rami and the superior rim of the root of transverse process in both sexes are:L_(1)3.73 mm,L_(2)3.68 mm,L_(3)3.67 mm,L_(4)3.02 mm,L_(5)1.74 mm.4.The occurrence of anastomosis between successive lateral divisions of the posterior ramus is as follows:(1)Anastomosis between L_(1)/L_(2) being 50 cases(62.5%).(2)Anastomosis between L_(2)/L_(3) being 50 cases(62.5%).(3)Anastomosis between L_(3)/L_(4) being 11 cases(13.75%).(4)Anastomosis between L_(4)/L_(5) being 3 cases(3.76%).5.Three hundred cases(82.50%)of the nerve are accompanied by the vessel in passing through the osteo-fibrous canal,while 70 cases(17.50%)are not accompanied by the vessel.Further more,the authors discussed the inter-relationship between the morphology of the nerve and the osteo-fibrous canal in clinical standpoint of view.