女性骶棘韧带区域应用解剖研究

Applied anatomy study of female sacrospinous ligament

目的研究女性尸体标本骶棘韧带(sarospinous ligament,SSL)的解剖特点及其毗邻,为骶棘韧带固定术提供解剖学参考。方法对24具女性尸体进行解剖,测量相关参数。结果SSL长度右侧为(5.11±0.30)cm,左侧为(5.10±0.36)cm;两侧长度无明显差别。24具尸体阴部管最内侧均为阴部神经,其与坐骨棘距离为右侧(1.51±0.35)cm,左侧(1.61±0.31)cm。SSL薄且坚韧,所有标本的平均厚度约0.2 cm。尾骨肌位于SSL盆腔侧,层厚远大于SSL,且覆盖范围更大,二者联系紧密,重合部分可视为整体。臀下动脉均走行于SSL上缘及以上出骨盆,其中7条经坐骨棘端出骨盆。坐骨神经远离SSL。SSL盆腔面未见重要血管神经束。有少量血管及神经走行于SSL背侧。结论行骶棘韧带固定术时应选择离右侧坐骨棘至少1.51 cm、左侧至少1.61 cm处作为悬吊点。

Objective To study the characteristics of the sacrospinal ligament(SSL)and its adjacent vessels and nerves,and to provide anatomical basis for the sacrospinal ligament fixation(SSLF).Methods 24 female cadavers were dissected to measure the relevant anatomic parameters.Results The length of left was(5.10±0.36)cm,the right was(5.11±0.30)cm.There was no statistical difference between the length of left and the right SSL length.The inmost part of the pudendal canal was the pudendal nerve,The horizontal distance between the right pudendal nerve and the sciatic spine was(1.51±0.35)cm,the left side was(1.61±0.31)cm.SSL was thin but tough,the average thickness in all samples was about 0.2 cm.Coccygeus was located in the lateral side of SSL pelvic cavity.The thickness of the coccygeus was much larger than SSL with a wider cover.The inferior gluteal artery travelled dorsally through the SSL and leave of the pelvis,but 7 of them travelled through the sciatic spine.The sciatic nerve kept away from the SSL.There is no vessel and nerve traveling on the pelvic surface of SSL.Conclusions 1.51 cm away from the right sciatic spine and 1.61 cm away from the left sciatic spine may be the best suspension point for SSLF.