诊疗坐骨神经损伤的局部解剖学基础及临床分析

Regional anatomy and clinical analysis of injured sciatic nerve in diagnosis and treatment

目的探讨坐骨神经损伤的诊疗机制。方法对成人尸体标本15具30侧腰椎间孔的大小、长度、脊神经根粗细及坐骨神经出骨盆处进行观察测量。结果腰椎间孔的大小是自上而下逐渐变小:L1(11.65±1.55)mm,L5(9.98±1.57)mm;椎间孔长度逐渐增大:L1(6.84±1.35)mm,L5(11.17±1.77)mm;腰、骶神经根自发出点到椎间管内口的长度逐渐增加:L1(8.10±2.60)mm,S1(23.80±3.11)mm;神经根的直径自上而下也逐渐变大。坐骨神经出骨盆处发现2具4侧异常型。结论坐骨神经起始部至臀段区域之间受到压迫都可以使坐骨神经受到影响。

Objective To discuss the diagnosis and treatment of the injured sciatic nerve. Methods The size and length of lumbar foramen intervertebral, the caliber of the spinal nerve root and the place of sciatic nerve going out from the pelvis of the 15 adult（30 sides） corpses were observed and measured. Results The size of the foramen intervertebral shrinked from the top downward, that is L1 （ 11.65 ± 1.55） mm,L5 （9.98 ± 1.57） mm,and the length increased as this： L1 （6.84 ± 1.35） mm, L5 （ 11.17 ±1.77） mm. the length of lumbar nerve and sacral nerve root from the starting point to the intervertebral foramen gradually increased, L1 （8. 10 ± 2.60 ） mm, S1 （23.80 ± 3.11 ） mm. The diameter of nerve root became bigger from top downward. The sciatic nerve going out from the pelvis of 2 corpse（4 sides） were anomaly. Conclusion The sciatic nerves could be involed by the oppression between the initiation and buttocks.