论文部分内容阅读
目的 :为脊髓圆锥部进行SPR和SAR手术提供定位、入路和辨认神经根的解剖学依据。方法 :选 14具儿童脊柱标本 ,显露脊髓圆锥及其马尾神经。观测该区域神经根位置、形态及其与周围组织的关系。结果 :脊髓圆锥末端大多数平对L1椎板。L1神经根硬膜出口亦位于L1椎板范围内 ,神经根在该区域按顺序排列。S1后根最粗 ,S2 明显变细 ,S3～ 5最细。神经后根进入脊髓角度以L5最大 ,S1其次 ,S2 角度骤然变小 ,与脊髓接近平行。结论 :仅处理L1椎板即可满意显露所需处理的神经根。 6cm皮肤切口即可达显露要求。根据终丝 ,L1神经根硬膜出口 ,S1和S2 的形态特征以及节段血管等四个方面综合鉴别能准确辨认神经根。
OBJECTIVE: To provide an anatomical basis for positioning, approach and identification of nerve roots for SPR and SAR surgery of the conical portion of the spinal cord. Methods: 14 children with spinal specimens were selected to reveal the spinal conus and cauda equina. Observation of the nerve root location, morphology and the relationship with the surrounding tissue. RESULTS: Most of the spinal conical ends were flat against the L1 lamina. L1 nerve root dural outlet is also located in the L1 lamina range, the nerve root in the region in order. S1 after the root of the most thick, S2 significantly thinner, S3 ~ 5 the smallest. Nerve posterior root into the spinal cord angle to the largest L5, followed by S1, S2 angle suddenly smaller parallel with the spinal cord. CONCLUSIONS: Only the L1 lamina can be satisfactorily exposed to the nerve root in need of treatment. Skin incision 6cm up to reveal the requirements. According to the final filament, L1 nerve root dura exit, S1 and S2 morphological features and segmental blood vessels in four aspects of comprehensive identification can accurately identify the nerve root.