T12～L5椎体软组织夹板的解剖学研究及其临床意义

目的:探讨T12~L5椎体周围软组织的解剖学特点,为胸腰椎骨折的诊疗提供新思路。方法:在21具脊柱标本上对前纵韧带、膈肌脚、腰大肌、后纵韧带及椎间盘的形态特点及毗邻关系进行观测。结果:双侧膈肌脚、腰大肌与前、后纵韧带将脊柱胸腰段及腰椎紧密包围其中,形成软组织夹板,各椎间盘将各椎体分隔,形成独立的软组织间室。结论:提出T12~L5椎体软组织夹板的概念,该夹板由双侧膈肌脚、腰大肌与前、后纵韧带组成,诊断胸腰椎骨折时应注意该夹板的完整性;治疗时要利用T12~L5椎体软组织夹板对骨折进行复位,以达到解剖学复位的目的。

Anatomy of Soft Tissue Splint Around the Vertebrae of T12～L5 and Its Clinical Significance

Objective:To discuss the characteristics of soft tissues surrounding the vertebrae from T12 to L5, in order to provide a new idea for the diagnosis and treatment of the fractures of thoracolumbar vertebraes. Methods:The morphological features of anterior longitudinal ligament, diaphragma pars, greater psoas muscle, discus interverbralis and posterior longitudinal ligament, and adjacent relationship among these tissues were observed in 15 spine specimens. Results:In all specimens, the bilateral diaphragma pars, greater psoas muscle, anterior and posterior longitudinal ligament composed a soft tissue splint which tightly surrounded the vertebrae body in thoracolumbar spine, meanwhile, the discus interverbralis separated vertebrae bodies from each other, so the independent soft tissue compartment was formed. Conclusions: The term of soft tissue splint was proposed in this article, the splint consisted of the bilateral diaphragma pars, greater psoas muscle, anterior and posterior longitudinal ligament.The integrality of splint should be considered in the diagnosis and treatment of fractures of thoracolumbar vertebra. Utilizing the splint to reduct the fractures could win the anatomic reposition.