胸腰段椎间孔的解剖学观测及其临床意义

Anatomical observation on the thoracolumbar intervertebral foramen and their clinical significance

目的 :观测胸腰段椎间孔的形态结构特征 ,为临床提供解剖学参数。方法 :对 2 4具正常成年男性尸体脊柱胸腰段椎间孔 (T1～L5)的前后径、上下径及椎间孔长度进行了观测。结果 :前后径 :T1～T4依次增大 ,T5～T8无明显变化 ,T9～T12 依次增大 ,L1～L5依次变小 ;上下径 :T1～L4依次增大 ,L5略小于L4,T1～L5均明显大于其前后径 (P <0 .0 1) ;椎间孔长度 :T1～T4依次明显变小 ,T5～T8无明显变化 ,T9～T12 依次增大 ,L1～L5依次增大 ;脊神经根位于椎间孔上半部 ,椎间孔与脊神经根之间的间隙上下径较大 ,前后径较小。结论 :胸段椎间孔狭窄压迫脊神经根的机率低于腰段 ,椎间孔下半部狭窄不压迫脊神经根 ,椎间孔狭窄自上下方向压迫脊神经根的机率低于前后方向。

Objective To observe the morphological features of the thoracolumbar intervertebral foramen and to provide anatomical data for clinic practive.Methods The height, length and sagittal width of the thoracolumbar intervertebral foramen from T 1 to L 5 were measured in 24 adult male skeletons.Results The sagittal width increased gradually from T 1 to T 4 and from T 9 to T 12, decreased gradually from L 1 to L 5;The height of intervertebral foramen gradually increased from T 1 to L 4, and were significantly greater than the corresponding sagittal width from T 1 to L 5 (P<0.01);The length of intervertebral foramen decreased significantly from T 1 to T 4 and increased gradually from T 9 to L 5; the spinal nerve roots were located in the superior part of the intervertebral foramen and the space between them were larger in vertical orientation, smaller in sagittal orientation.Conclusion The spinal nerve roots lesions due to the stenosis of intervertebral foramen occur more frequently in the thoracic region than in the lumbar region and are usually found in sagittal direction.