腰椎小关节周围脊神经后支内侧支分布的特点及其临床意义

Distribution characteristics of the medial branch of the posterior branch of the spinal nerves around the lumbar facet joints and its clinical significance

目的通过对腰部关节突关节周围脊神经后支内侧支分布解剖观察,探讨去神经术中脊神经后支内侧支的定位和靶点的选择。方法对5具尸体的腰部关节突关节区域进行局部解剖,观察关节突关节周围肌肉的配布情况、脊神经后支的分支情况,脊神经后支内侧支的走行、分支和分布,与上关节突、横突和关节突关节的关系,测量了骨纤维管的内侧开口、关节突关节囊和上关节突距棘突边缘连线的距离。结果关节突关节及周围结构的解剖显示,脊神经后支分出的内侧支紧贴上关节突和横突根部走行,不易探查和解剖;脊神经后支内侧支从骨纤维管穿后,斜向内下方走行,较容易追踪。结论在脊神经后支内侧支从骨纤维管穿后进行去神经操作可以提高去神经术操作安全性和有效性。

Objective To examine the distribution characteristics the medial branch of the posterior branch of the spinal nerves around the lumbar facet joints, so as to explore the localization and targeting of the medial branch of the posterior branch in neurectomy. Methods Five corpses were dissected, and the anatomical relationships between the medial branches of the posterior branch of the spinal nerves and the facet joints were examined. Measured the distances from the lateral port of the bone fiber tube ,the articular process of the facet joint and the superior articular process to the spinous processes. Results The medial branch of the posterior branch of the spinal nerve was close to the root of the articular process and the transverse process, which was not easy to be explored and dissected. Meanwhile, it was easily traced after the medial branch of the posterior branch of the spinal nerve ran through the fibrous tube. Conclusion It may improve the safety and effec- tive when the techniques of medial branch block is performed after the medial branch ran through the fibrous tube.