腰神经根被膜的显微解剖学观察及其临床意义

THE MICROSURGICAL ANATOMICAL OBSERVATION OF THE LUMBAR NERVE ROOT CAPSULES AND CLINIC SIGNIFICANCE

为探讨神经根被膜的结构特点及其临床意义 ,本研究通过光镜及电镜对 10例 ( 2 0侧 )新鲜胎尸的共 10 0条腰段神经根和部分坐骨神经、腓总神经进行了显微解剖、组织学观察和比较。结果证明 ,神经根被膜与周围神经干被膜之间存在差异。腰段神经根的硬膜囊内段前、后根由很薄的软脊膜覆包 ,而各小束束膜为更薄的类似软脊膜的被膜包裹 ;硬膜外腔段神经根被它所带出的软脊膜、蛛网膜和硬脊膜包裹 ,被膜厚度随层次增加而增加。神经根的被膜与周围神经干被膜相比较薄且层次少 ,层与层之间的连接相对松散。上述结果提示 ,神经根被膜与周围神经干被膜相比 ,其韧性及抗张力能力相对较脆弱 ,存在着易受损伤的潜在因素 。

The prosent study was to explore the structure of lumbar nerve root capsules and their clinic significance. The lumbar nerve roots, sciatic nerves and common peroneal nerves were observed and compared under light and electron microscope with microsurgical anatomy and histology technology in 10 cases (20 sides) novelty fetus cadaver. The capsules of nerve roots and peripheral nerve trunk were different. The epidural bursa inner sect of nerve roots was covered by thinner spinal pia mater. Moreover the fasciculus was enwrapped in much thinner capsules which were similar to spinal pia mater. The nerve roots in epidural space segments were enwrapped in spinal pia mater, arachnoid and spinal dura mater, and the thickness of capsule gradually increased as layers grew. The capsules of nerve roots were thinner and the layers were less compared with the peripheral nerve trunk, the connection between layers was loose. The results indicate that the resistance to tenacity and strain of nerve root capsules are relatively infirm and their ability to resist chemical stimulation is weaker compared with the peripheral nerve trunk. (Figures 2～6 on plate 37)