腰神经后内侧支与骨纤维管的解剖学研究

Anatomical study of the medial branch of the lumbar posterior ramus and the bone fibrous canal

目的 :为探讨腰神经后内侧支在乳突副突间沟骨纤维管 (简称骨纤维管 )处受压的有关解剖因素。方法 :在 2 0具成人尸体标本上 ,观察腰神经后内侧支及与其有关的解剖结构 ;分别测量骨纤维管的大小、乳突副突间韧带的厚度以及体表定位。结果 :腰神经后内侧支的直径 L1～ 4均数为0 .79m m,L5 为 0 .6 5 m m ;骨纤维管的纵、横径均数 L1～ 4基本相近 ,分别为 2 .2 0 mm ,1.71mm左右 ,而 L5 分别为 1.12 mm、1.30 mm ;乳突副突间韧带的厚度 ,L3～ 5 分别为 2 .0 7mm、2 .0 3mm、1.91mm ;体表定位在相对应的各腰椎平面距后正中线外侧约 2 0～ 2 5 mm处。结论 :在腰神经后内侧支的行程中存在多处受压的解剖因素 ,其中以骨纤维管内的一段更为明显 ,这为临床治疗腰腿痛提供了解剖学基础。

Objective:To study the anatomical factors of the compression of the medial branch of the lumbar posterior ramus in the bone fibrous canal.Methods:The medial branch of the lumbar posterior ramus and its relative anatomical structure,the diameter of the bone fibrous canal,the thickness and position of superocllateral ligament were observed on 20 adult cadavers.Results:The diameters of medial branch of the lumbar posterior ramus L 1～4 were 0.79mm,L 5 0.65mm, the tongitudinal and transverse diameters of bone fibrous canal L 1-4 were 2.20mm and 1.71mm, L 5 1.12mm and 1.30mm;superocollateral ligaments L 3～5 were 2.07mm,2.03mm,and 1.91mm in thickness respectively;the locations were 20～25mm on the both side of the middle line of corresponding lumbar vertebra.Conclusion:There were several compression factors along the course of the medial branch of the lumbar posterior ramus,among them,the length in bone fibrous canal was more obvious.This provides an anatomical basis for clinical treatment of lumbar-legs pains.