胸椎椎间孔外韧带的解剖学观测

目的对T1~12椎间孔外口区域的韧带进行解剖学研究并探讨其临床意义。方法对10具成人尸体标本的240个T1~12椎间孔进行解剖观测。鉴别所有出现的韧带,观察并记录T1~12椎间孔外口区域椎间孔外韧带的数量、形态、分布、起止位置和毗邻,并用游标卡尺分别测量每条韧带的长度、宽度和厚度。结果在229个胸椎椎间孔外口区域共发现564个椎间孔韧带,另11个椎间孔外口区域未发现韧带,椎间孔外韧带的出现率为95.42%。韧带有2种类型,放射型占24.11%(136个),横跨型占75.89%(428个)。放射型韧带在T1及T9~12节段较为常见,而在T2~8节段则相对较少。其中有43.44%(245个)韧带分布于椎间孔外口区域的前部,39.89%(225个)分布于后部,11.35%(64个)分布于上部,5.32%(30个)分布于下部。结论胸椎椎间孔外口区域存在2种类型的韧带;其中放射型韧带可能是一种脊神经抗牵拉的结构,对脊神经起到固定和保护作用,横跨型韧带可能是胸椎压缩性骨折后肋间神经痛的潜在原因之一。

Anatomical observation and measurement of the thoracic extra-foramina ligaments

Objective　To proceed the anatomical research on the ligaments in the exit regions of the T1~12 intervertebral foramina and to discuss its possible clinical significance. Methods Two hundred and forty T1~12 intervertebral foramina from 10 adult cadavers were dissected and observed. All the ligaments that appeared were identified. The number, morphology, distribution, starting and ending position and the adjacency of the ligaments were observed and recorded. The length, width and thickness of each ligament were measured by vernier calipers. Results 564 extra-foramina ligaments were found in 229 intervertebral foramina, while there were no ligaments in the remaining 11 intervertebral foramina. The occurrence rate of extra-foramina ligaments was 95.42%. There were two types of ligaments: radiating ligaments accounting for 24.11%（136 cases) and transverse ligaments accounting for 75.89% (428 cases). It was relatively common for the radiating ligaments in the segment of T1 and T9~12, but sparse in the segment of T2~8. Of these, 43.44% ligaments (245 cases) were located in the anterior part of the exit regions of the intervertebral foramina, 39.89% ligaments (225 cases) in the posterior, 11.35% ligaments (64 cases) in the upper part, 5.32% ligaments (30 cases) in the bottom part. Conclusions There are two types of ligaments in the exit regions of thoracic intervertebral foramina. The radiating ligament may be a kind of protective mechanism against traction, which can fix and protect the spinal nerve. Transverse ligaments may be one of the potential causes of rib or chest pain after thoracic compression fracture.