胸腰段脊柱脊髓重度损伤及相关解剖学研究

Severe thoraco-lumber spine injury and related anatomical research

目的 :了解腰段脊神经的解剖特点及这些解剖特点在胸腰段脊柱脊髓重度损伤时的诊断和治疗意义。方法 :通过 2 0例局解研究观测腰段脊神经与椎体平面之间的关系 ,脊神经的形态及移位情况。随访 14 3例胸腰段脊柱脊髓损伤病人 ,对比观测环行减压和单纯椎板减压的效果。结果 :腰段脊神经与椎体平面有相对固定关系 ,L1脊神经到L5脊神经逐渐增粗 ,它们在冠状面上虽可向对侧移位但不超过中线。环行减压组有 8例术后神经功能障碍进一步加重。结论 :胸腰段骨折行环行减压时要特别注意保护脊神经 ,避免过分牵拉加重损伤。

Objective:To understand the anatomical characteristic of spinal cord root and the significance for diagnosis and treatment in spinal cord injury.Methods:The shape,shift of spinal cord roots and the relationship of segmental level between the spinal cord and vertebrate were observed in twenty cadavers.Meanwhile,143 patients with thoraco-lumber spine injury were followed up to compare the treatment results between the simple laminectomy decompression and annular decompression.Results:The relationship between lumber nerve and vertebrate is relatively stable.The diameter of spinal nerve is increased from L 1 to L 5.they could be shifted to the opposite side but not beyond the mid line.The post operation nerve impediments in eight patients in the group with annular decompression were worse.Conclusion:It must be pay attention not pull the nerve too hard to injury the spinal nerve during the surgery of annular decompression in thoraco-lumber spine fracture.