上下肢相应脊神经后根的应用解剖学研究

Anatomy of the Spinal Posterior Roots in the Upper and Lower Limbs

目的 为各种后根切断术的应用、改良提供有价值的解剖学依据。方法 采用 10具成人脊柱标本 ,切除后部结构 ,打开硬膜 ,观察上、下肢相应脊神经后根的形态和走向。结果 C5-T1后根入脊髓处对应C4 椎体中 1/ 3至T1椎体上 1/ 3之间 ;L1-S2 后根入脊髓处对应T10 椎体上 1/ 3至L1椎体下 1/ 3之间。上下肢相应后根入脊髓前分成数支小束 ,数目相对恒定 ,呈纵形排列进入脊髓后外侧裂。结论 各种SPR手术在上肢均需广泛切开椎板 ;在下肢则可行限制性椎板切除完成手术。于上、下肢脊神经后根入脊髓处行SPR 。

Objective To provide anatomical bases for different SPR.Methods The posterior roots in the upper and lower limbs were measued and observed on 20 adult spine specimens.Results The spinal cord entrance of C 5～T 1 posterior roots correspond between the middle 1/3 C 4 and upper 1/3 T 1.The spinal cord entrance of L 1～S 2 posterior roots correspond between the upper 1/3 T 10 and lower 1/3L 1.All there posterior roots are respectively composed of relatively constant sum of rootlets,and arranged longitudinally in the latdral posterior sulcus of spinal cord. Conclusion Different SPR need extensive laminectomy in upper limbs,and only limited laminectomy in lower limbs.SPR close to the spinal cord entrance of posterior root can avoid the injury of divided artificial rootlets and blood support influence.