胸腰段脊髓动脉的解剖学

Anatomical observation of the thoracolumbar spinal cord arteries

目的：系统研究胸腰段脊髓动脉的局部解剖关系,明确胸腰段脊髓动脉分布及吻合情况.方法：选用50例脊髓动脉完整无损的成年尸体标本,解剖并观察胸腰段脊髓动脉及其动脉之间的走行分布及吻合情况.结果：胸腰段脊髓动脉主要为脊髓前后正中动脉和Adamkiewicz动脉.脊髓前、后正中动脉与各肋间后动脉、腰动脉发出脊髓支之间存在吻合,胸、腰段发出的根动脉吻合率左、右侧比较差异无统计学意义,胸段与腰段比较差异有统计学意义,且腰段吻合率高于胸段.Adamkiewicz动脉起源平面最高为第6胸椎,最低第3腰椎,大多起源于左侧第8胸椎～第1腰椎水平.结论：脊髓前、后正中动脉在胸段脊髓起关键作用;Adamkiewicz动脉对腰段脊髓动脉起关键作用.胸腰段脊髓动脉之间存在广泛吻合.第10胸椎～第1腰椎平面是胸腰段脊髓动脉吻合的相对缺乏区.

Objective： To systematically study regional anatomy of thoracolumbar spinal cord arteries, and to identify distribution and anastomosis of the thoracolumbar spinal cord arteries. Methods ： We selected 50 samples of adult corpses with undamaged spinal cord arteries, anatomized and observed the shape and distribution of the spinal cord arteries and the anastomosis between them.Results：The main thoracolumbar spinal cord arteries were the anterior spinal cord and posterior spinal cord and Adamkiewicz artery. There were anastomosis relationships among the anterior median spinal artery, the posterior spinal artery, and the spinal cord arteries branched from the lumbar arteries. There was no significant difference in inosculation between the left and right radicular arteries from the lumbar and thoracic, and there was significant difference between the lumbar and pectoral. The lumbar anastomosis was higher than pectoral. Adamkiewicz arteries originated ranging from thoracic spine 6th at the highest down to lumbar spine 3rd at the lowest, and most originated on the left thoracic spine 8th to lumbar spine 1st level. Conclusion： The anterior and posterior spinal cord arteries play a key role in the pectoral spinal cord, and the Adamkiewicz artery plays a key role in the lumbar spinal artery. The thoracolumbar spinal arteries are widely anastomosesed. The level of the thoracic spine 10th to the lumbar spine 1st thoracolumbar spinal cord is relatively lack of arterial anastomosis.