胎儿胸椎间孔韧带的观测及意义

目的:通过胎儿胸椎间孔韧带的观测,为国人提供胎儿胸椎间孔韧带的解剖学资料。方法:选用足月胎儿尸体标本15具,解剖观察胸椎间孔韧带,用游标卡尺进行相关测量。结果:在30侧胸椎标本中未发现横孔上韧带和体横韧带,T1￣T12均发现横孔下韧带,其出现率从T1￣T12分别为10.0%、10.0%、23.3%、30%、46.7%、53.3%、76.7%、80.0%、80.8%、86.7%、90.0%、86.7%;T3￣T12横孔下韧带的长度随着椎骨序数的增加而有逐渐增加的趋势。结论:胎儿胸椎间孔韧带普遍存在,其为胸椎的正常组织结构,对胸椎神经根管内的结构具有固定、支持和保护作用。     

腰椎间孔韧带的解剖观测及其临床意义

目的:观察腰椎间孔韧带的形态及特点,以探讨其在腰腿痛发病机制中的作用。方法:取正常人体腰椎防腐标本,解剖椎间孔区,对椎间孔韧带的起止点、形态特征和分布特点等进行观测。结果:所有标本均含有椎间孔韧带,８０%椎间孔存在韧带组织,韧带以上腰椎多见,左右椎间孔韧带分布无对称性。椎间孔韧带平均厚度(０．３６ ± ０．４４)ｍｍ,以带状韧带为主。椎间孔垂直径、神经根孔垂直径和神经根直径分别为(１７．０９±２．９２)ｍｍ、(１１．１９±３．０６)ｍｍ、(４．３７±１．０８)ｍｍ。横孔韧带多分布在上位椎间孔,体横韧带多见于Ｌ５Ｓ１椎间孔处。结论:①腰椎间孔韧带形态变异较大,分布广泛而有一定的规律,应为正常的组织结构;②当椎间孔周围组织出现退变时,椎间孔韧带的存在可能会增加血管和神经根遭遇受挤压的危险性。     

成人胸椎间孔韧带的解剖学观测

目的 通过解剖观测成人胸椎间孔韧带.为国人提供胸椎间孔韧带的解剖学资料并探讨其临床意义.方法 选用成人尸体标本15具,解剖观察胸椎间孔韧带.用游标卡尺进行相关测量.结果 在30侧成人胸椎标本中未发现横孔上韧带和体横韧带.T1椎间孔内未发现横孔下韧带,T2～T12椎间孔内均发现横孔下韧带,其出现率从T2～T12呈逐渐增加...     

腰部椎间孔韧带的观测

用胎儿，儿童及成人脊柱标本，共２０例，研究腰部椎间孔韧带，在上述标本中均发现椎间孔韧带，共１９５条，其中横孔上韧带２０条，横孔下韧带１１９条，体横上韧带３１条，本横下韧２５条。横孔上，下韧带带主要分布于上腰部椎间孔内，尤以Ｌ１椎间孔内多见。     

腰椎横突间韧带的解剖学观测及意义

目的　通过对腰椎横突间韧带的解剖学观测,为极外侧型腰椎间盘突出症的手术治疗提供解剖学基础。 方法　15具经防腐固定的成人尸体标本,解剖观测腰椎横突间韧带,用游标卡尺测量其长度、宽度和厚度。 结果　L1~2横突间韧带长度（1.67±0.39）cm,宽度（0.80±0.23）cm,厚度（0.09±0.04）cm;L2~3横突间韧带长度（1.80±0.35）cm,宽度（0.94±0.23）cm,厚度（0.09±0.06）cm;L3~4横突间韧带长度（1.72±0.25）cm,宽度（0.95±0.21）cm,厚度（0.09±0.03）cm;L4~5横突间韧带长度（1.50±0.20）cm,宽度（1.04±0.23）cm,厚度（0.09±0.04）cm。 结论　腰椎横突间韧带为经横突间入路（含内窥镜下）治疗极外侧腰椎间盘突出症的重要解剖学标志,熟悉其解剖形态特点对于此类手术具有重要意义。     

胸椎椎间孔外韧带的解剖学观测

目的对T_1～12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T_1～12椎间孔进行解剖观测。鉴别所有出现的韧带,观察并记录T_1～12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T_9～12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...     

颈椎椎间孔外口区韧带的解剖学观测

目的　对颈椎C_2~7椎间孔外口区域的韧带进行解剖学描述并探讨其临床意义。 方法　对10具成人尸体标本的 100个椎间孔进行解剖观测。鉴别所有出现的韧带,观察并记录C2~7椎间孔外口区域椎间孔外韧带的数量、形态、分布和起止位置。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100个椎间孔外口区域共发现252个椎间孔外韧带。椎间孔外韧带可以分为放射型韧带236 个(93.7 %)和横跨型韧带16个(6.3 %)两种。放射型韧带将神经根连接到周围结构,可分为上方韧带（25.0%）,下方韧带（60.2%）,前方韧带（6.3%）和后方韧带（8.5%）;横跨型韧带与神经根相垂直并横跨于神经根上,其中,横跨型韧带在C4~5节段最为常见,在C4~5节段的平均长度为横跨型韧带长度为(8.12±1.38) mm(6.28~9.93 mm),厚度最厚可达1.04 mm,每个颈椎椎间孔最多只有一条横跨型韧带。 结论　椎间孔外韧带是椎间孔正常的生理结构,可能与颈椎减压术后C5神经麻痹的发生有关。在颈椎减压术后,横跨型韧带可能是造成神经根卡压而引起神经损伤的潜在原因之一。而放射型韧带可以限制脊神经移位,可能因此牵拉神经引起损伤。     

颈椎间孔韧带的解剖特点及其临床意义

神经根型颈椎病是临床常见疾病,可引起上肢感觉或运动障碍,其病因可能是神经根受到各种直接机械压迫[1]。神经根自硬膜囊发出后向外下方走行,经椎间孔出椎管,椎间孔内软组织增生、肥厚、粘连等病理改变均可使经过该处的神经根受到压迫,导致出现相应的临床症状如放射性上肢疼痛、麻木或无力等。想要更清楚地了解神经根卡压的机制,需要对颈椎间孔区域进行更加深入的解剖学研究。掌握颈椎间孔韧带的解剖特点有助于提高神经根型颈椎病的诊断和治疗水平,在该区域手术操作时尽可能地减少医源性损伤。有关胸腰椎(T1~5)的椎间孔韧带研究证明其韧带起到限制神经根移位并防止拉伤的作用[2~4]。然而,目前关于颈椎间孔韧带的研究尚少。本文结合国内外文献资料,对颈椎间孔韧带的相关知识作一综述。     

胸、腰椎上关节突棘的观测及临床意义

目的:通过对胸、腰椎上关节突棘形态的观测,为临床提供解剖学资料.方法:选用35例成人、2例儿童的完整干燥脊柱标本及5例胎儿脊柱湿标本,观察上关节突棘,用游标卡尺进行相关测量,结果:成人的颈椎、T1和L5及儿童和胎儿的全部脊柱标本上未观测到上关节突棘的存在,成人其余的胸椎和腰椎上均观察到上关节突棘,而且卜关节突棘多出现在下胸椎和L1,随着胸椎序数的增加上关节突棘的出现率有增加的趋势;随着腰椎序数的增加,上关节突棘的出现率有减少的趋势.结论:上关节突棘是成人胸、腰椎的骨性结构,有必要对其予以命名;其参与椎管和椎间孔的构成,可造成相应结构受压.     

肾型n-HA/PA66腰椎间融合器在经椎间孔腰椎椎体间融合术中的有限元分析

目的　设计一种新型的“肾形”n-HA/PA66腰椎间融合器(cage),通过三维有限元分析,研究其在经椎间孔腰椎椎间融合术(TLIF)中的生物力学特性。 方法 建立正常人体L3-L5节段三维模型,模拟经椎间孔腰椎椎间融合术,采用有限元分析方法进行应力分析,比较肾型与子弹头型n-HA/PA66腰椎间融合器应力分布的差异。 结果　在前屈、后伸、左右旋转工况下两种不同cage的TLIF手术模型对比,子弹头型cage最大应力分别为32.8、32.8、31.4、31.3、32.8、34.2 MPa,肾型cage最大应力分别为13.2、11.4、10.9、10.1、11.7、11.1 MPa;而且肾型cage应力集中区域小于子弹头型cage。 结论　肾型n-HA/PA66腰椎间融合器固定的椎体应力分布小而均匀,理论上可有效降低cage沉降率。     

Ligaments of the lumbar neural foramina: A sectional anatomic study

The ligaments of the lumbar neural foramina have not been systematically described. We sectioned the lumbar spines of 15 cadavers in the sagittal plane with a cryomicrotome and identified the ligaments in the neural foramina. Fibrous ligaments were identified in every lumbar neural foramen. The most constant ligament was a band of fibrous tissue behind the anulus fibrosus and distinct from it, originating in one vertebral body and inserting in the next. Ligaments connecting the posterior disc margin and the superior articular process were found in 48% of the neural foramina. A band of fibrous tissue originating from the anulus fibrosus and inserting along the pedicle and superior articular process was found in 44% of the foramina. Three other distinct types of ligament were found less commonly. Ligaments, which some investigators believe may contribute to lateral spinal stenosis, are commonly present in the neural foramina.     

Nerve root to lumbar disc relationships at the intervertebral foramen from a surgical viewpoint: An anatomical study

The objective of this study was to analyze relationship of the intervertebral disc to the nerve root in the intervertebral foramen. Fourteen formalin-fixed cadavers were studied and measurements were performed. At the medial line of the neural foramen, the disc-root distance gradually increased from L1-L2 to L5-S1. The shortest distance between the disc to nerve root was L1-L2 (mean, 8.2 mm) and the greatest distance was found at L3-L4 (mean, 10.5 mm). In the mid-foramen, the disc-root distance decreased from L1-2 to L5-S1. The shortest distance from the disc to nerve root was found at L5-S1 (mean, 0.4 mm); and the greatest distance, at L1-L2 (mean, 3.8 mm). For the lateral line, the distance between an intersection point between the medial edge of the nerve root and the superior edge of the disc and lateral line of the foramen consistently increased from L1-L2 to L5-S1. The shortest distance from nerve root to the lateral border of the foramen, at the point where the nerve root crosses disc was at level L1-L2 (mean, 2.6 mm), the greatest distance, L5-S1 (mean, 8.8 mm). The width of the foramina progressively increased in a craniocaudal direction (mean, 8.3-17.8 mm from L1-2 to L5-S1, respectively). The mean height of the foramina was more or less the same for disc levels (range, 19.3-21.5). The results showed that nerve roots at lower levels traveled closer to the midline of the foramen. This morphometric information may be helpful in minimizing the incidence of injury to the lumbar nerve root during foraminal and extraforaminal approaches.     

腰椎棘突间区的解剖学参数及临床意义

目的：为腰椎棘突间内固定器械的设计和临床应用提供解剖学依据。方法：测量52具成人完整福尔马林固定标本T12-S1。段脊柱的棘突间距、棘突顶距、棘突长度、相邻棘突上下缘及中央厚度。测量数据用SPm115。软件行方差和相关性分析。结果：各组数据满足正态性、方差齐性。棘突间距从上到下逐渐减小，L1～2为7．61mm（女，7．75），L5～S1为4．03mm（女，6．49）。棘突顶距、棘突长度中段较大，上段和下段较小。棘突顶距，T12～L1为54．63mm（女，54．63），至L2-3，增大为60．18mm（女，53．64）又逐渐变小，至L4～5，减小为45．07mm（女，49．40）。棘突长度，L3最大，25．45mm（女性L4最大18．71mm），L1和L5分别为21．63mm（女，17．08）和21．41mm（女，17．44）。相邻上-棘突下缘厚度普遍大于下一棘突上缘厚度。差值呈偏态分布，中位数为3．28，75％位数为5．13。棘突顶距与身长呈中低度正相关。相邻椎间隙指标呈中高度正相关。女性较男性棘突较短、薄、矮。结论：该研究为腰椎棘突间内固定器械的设计提供了解剖学依据。     

Anatomic morphology and clinical significance of intraforaminal ligaments of the cervical spine

The cause of cervical spondylotic radiculopathy could be related to the intraforaminal ligaments (IFLs) of the cervical spine. The aim of this study is to identify and describe the IFLs and assess their clinical significance. Six intact cervical spine specimens from adult embalmed cadavers were dissected to expose the cervical nerve roots and their surrounding intraforaminal tissues fully. From the C1‐C2 to the C7‐T1 intervertebral foramina (IVF), the connective structures between each nerve root and its surrounding foraminal wall were examined under a surgical microscope. The morphology, number, and attachment points of the IFLs of each segment were documented, and the length, width, or diameter and thickness of the ligaments were measured with a vernier caliper. IFLs were observed in all 84 IVFs of the cervical spine. According to their locations, they can be divided into two categories: the first is entrance‐zone IFLs, which are radially distributed around the nerve root; the second is mid‐zone IFLs, which are thin, strip‐shaped fibrous tissues intertwined around the nerve roots, the number of ligaments being considerable but difficult to quantify. Ligament structures have been identified in the IVF of the cervical spine. Under physiological conditions, they could be protective in maintaining the position, shape, and function of nerve roots. However, under pathological conditions, the IFLs of the cervical spine could aggravate the symptoms of cervical nerve root radicular pain associated with other types of compression. Clin. Anat. 32:654–660, 2019. © 2019 Wiley Periodicals, Inc.     

颈神经根槽和颈椎间孔的应用解剖

目的：为颈椎病的病因、诊断和治疗提供补充的定量数据。方法：在干燥的颈椎椎骨标本和福尔马林固定的颈椎标本上，测量颈神经根槽和颈椎椎间孔。结果：内侧区的平均长度，内侧区前缘中点到椎体中线的距离从C3～C7逐渐增加。C3内侧区的宽度较大，C7上、下关节突及峡部高度之和的后中点到颈神经根槽后壁的前后距离最小。结论：研究结果为影像诊断和外科手术提供了相关的应用解剖数据。     

膝关节交叉韧带和侧副韧带的断面解剖学研究及其意义

目的研究膝关节交叉韧带和侧副韧带的断面形态特征和变化规律,为诊断膝部韧带病变提供更为详尽的形态学资料。方法利用27例正常成人膝关节标本制作连续断面,其中矢状断面9例,冠状断面12例,横断面6例。通过横、矢、冠状断面标本,观测膝关节韧带的断面形态特征及定量测量。结果矢状面上测量前、后交叉韧带长度分别为(29.66±4.21)mm、(40.26±6.81)mm,厚度分别为(10.03±1.97)mm、(11.24±3.50)mm。冠状面上前、后交叉韧带长径分别为(15.18±3.25)mm、(18.79±3.35)mm,短径分别为(6.37±1.32)mm、(8.03±1.46)mm;胫、腓侧副韧带长度分别为(102.85±19.64)mm、(45.52±14.91)mm,厚度分别为(2.63±0.72)mm、(3.43±1.04)mm。髁间隆起的横断面上胫、腓侧副韧带长径分别为(21.98±11.95)mm、(5.25±1.93)mm,短径分别为(2.03±0.59)mm、(2.87±0.64)mm。结论 (1)观测交叉韧带最好的断面是膝关节正中矢状面,其次是正中旁开1个矢状断面。除厚度外,在矢状面上前后交叉韧带长度、股、胫骨附着区宽度均有明显差异。(2)胫、腓侧副韧带在连续的冠状断面及横断面上均可显示,以冠状断面配合横断面相对为佳。