与胸12,腰1椎骨对应的腰骶神经根的应用解剖

在２０具（男１６，女４）成人尸体上，对胸１２、腰１椎骨对应的蛛网膜下隙内脊髓节、脊神经前、后根进行了应用解剖学研究。结果胸１２椎骨多与腰２￣５脊髓节、胸１２￣腰５神经根对应；腰１椎骨与骶１￣尾脊髓节、腰１￣尾脊神经根对应，据此，损伤时利于定位诊断。腰１￣３脊神经根远侧段与腰４￣骶３的近侧段之间常有一定长度的重叠，重叠的长度供神经缝接参考。文内还对神经根排列位置，前、后根的数目、长度和外径等进行了观     

电刺激排尿中圆锥部完全性骶部去传入的解剖学研究

目的:为从脊髓圆锥部进行完全性骶部去传入手术提供解剖基础。方法:解剖１０具成人脊柱脊髓标本,测量圆锥终末点至不同骶髓节段的距离。结果:脊髓圆锥长约３ｃｍ,位于Ｔ１２至Ｌ１椎体水平。从圆锥终末点Ｓ３和Ｓ２节段的长度分别为(１５．９±２．３)ｍｍ和(２１．６±２．７)ｍｍ。结论:在电刺激排尿时,切除圆锥终末背侧最远段２５ｍｍ的后根根丝,可完全切断Ｓ２及其以下的骶部传入纤维,获得彻底的膀胱去传入效果。     

膀胱伤害性刺激条件下大鼠腰骶髓后连合核及背根节内SP的动态…

将１０％福尔马林１．０￣１．５ｍｌ经尿道注入大鼠膀胱，于刺激后的０．５、１，２，８，２４，４８ｈ取材，进行免疫组化反应，观察脊髓腰骶段后连合核区的ＳＰ样纤维和终末的分布，并随机抽样进行图像分析，另设对照组，向膀销内注入生理盐水，０．５、２．０ｈ后取材，结果显示：福尔马林刺激后，腰骶髓后连合核区ＳＰ样阳性纤维和终末与对照组相比，在１ｈ内明显减少，而在２ｈ时则呈增加趋势，８ｈ又恢复正常，同时本文以同样     

终丝切断造瘘术治疗脊髓拴系合并末端脊髓空洞的疗效分析

目的探讨脊髓拴系合并末端脊髓空洞的临床特点,采用终丝切断造瘘的手术方式对其进行治疗并分析疗效。方法回顾性分析我院2011年1月至2018年12月收治的12例脊髓拴系合并末端空洞患者的临床资料。12例患者的空洞均向远端延伸形成终丝空洞,其中空洞位于腰骶部6例、胸腰骶部4例、颈胸腰骶(全脊髓) 2例;临床症状多表现为大小便功能和下肢远端感觉运动障碍,可合并脊柱侧弯、脊柱裂、脊髓纵裂和皮毛窦等其他神经管畸形。手术在显微镜下进行,采用终丝切断造瘘术,先游离并切断终丝,松解脊髓拴系,然后在切断的终丝末端做"V"型造瘘,达到引流脊髓空洞积水、防止空洞远端开口闭合的目的。根据脊柱裂神经功能量表记录患者术前及术后随访的运动功能、反射和大小便功能,通过神经功能评分和分级来评价手术效果。结果术后随访3个月至6年,全部病例空洞明显缩小或消失,临床症状均有不同程度改善,空洞无复发。结论对脊髓拴系合并末端空洞的患者采用终丝切断造瘘的手术方式治疗,创伤小,效果良好,可有效避免空洞复发。     

龟龄集对大鼠脊髓灰质内突触小泡蛋白变化的影响

目的：研究龟龄集对大鼠脊髓灰质内突触小泡蛋白的影响，探索龟龄集的抗衰老功效。方法：采用免疫组织化学结合图像分析法，对龟龄集喂药鼠和对照鼠的脊髓颈膨大、胸髓、腰膨大和骶尾髓灰质内突触小泡蛋白的免疫反应产物进行了观测。结果：对照和喂药鼠各自的脊髓各段后角内突触小泡蛋白免疫反应产物的灰度值不同，均以脊髓胸段最小，腰膨大最大；脊髓后角内免疫反应产物的灰度值均低于前角。对照组脊髓各段后角内突触小泡蛋白免疫反应产物的灰度值均明显高于喂药组。结论：龟龄集可延缓神经元的衰老，防止脊髓灰质内突触小泡蛋白的丢失，增强动物肢体感觉的灵敏性和活动的灵活性。     

马尾近端SPR的临床应用解剖学

目的：为限制性椎板切除的ＳＰＲ提供解剖学依据。方法：在２０例成人防腐灌注红色乳胶的脊柱标本上，对近端马尾神经进行巨—微解剖学观察。结果：马尾近端，Ｌ１前后根之间有最下一对齿状韧带，前根位于相应后根的前内侧。各节段后根在马尾近端呈冠状位的内外平排，从内向外依次为Ｓ２～Ｌ１的后根；各节段后根进脊髓处，Ｌ５和Ｓ１后根之间有明显分界线，相邻节段后根之间，均有恒定小静脉分隔。以终丝起点为定点，各节段后根与终丝之间的距离和成角从Ｓ２到Ｌ１逐渐增加。结论：在限制性椎板切除的ＳＰＲ术中，前、后根的鉴别主要依靠脊髓的外侧索和Ｌ１前后根之间的最下一对齿状韧带；后根节段的鉴别主要依靠后根连脊髓处，Ｌ５和Ｓ１之间有明显分界、相邻节段后根间有恒定小静脉来定性鉴别。也可根据终丝起点水平，各节段后根与终丝之间的距离和成角来鉴别后根节段     

原发病灶不清的腰与椎体转移性黑色素瘤继发腰骶神经根性症状1例报道

原发病灶不清的腰与椎体转移性黑色素瘤继发腰骶神经根性症状１例报道ＫｕＡ，ｅｔａｌ．ＡｒｃｈｐｈｙｓＭｅｄＲｅｈａｂｉｌ．１９９６Ｍａｒ；７７（３）：３０７～３０９脊柱恶性肿瘤继发腰骶神经根性症状很少见，无皮肤病灶的脊柱黑色素瘤更少见。本病例患者是４５...     

腰骶神经节的形态观测及其临床意义

在１５例３０例成人标本上，解剖观察了腰骶神经节的形态。位置及毗邻结构。根据神经膨大的近端与椎弓根的位置关系将神经切分为三型：①椎间孔型：神经节完全位于栓间孔内；②侧隐窝型：神经节膨大的近端位于椎弓根内缘上端的连线以外；③中央管型：神经节膨大的近端越过椎弓根内缘上端的连线突向中央椎管。讨论了神经节位置的变化及临床意义。     

腰骶神经根修复治疗截瘫

应用腰骶神经根修复治疗胸１２￣腰２骨折截瘫病人６例（男５，女１）获得成功，经１￣５年（平均２年）的随访均有部分功能恢复，特别是股四头肌和内收肌的功能恢复明显。作者认为胸１２、腰２椎骨骨折所致的截瘫为中枢和周转神经损伤并存，而后者通过神经根修复可取得较好疗效。     

儿童脊髓圆锥位置、硬膜下界、及内、外终丝的解剖学观察

所用材料是专供学生局部解剖的童尸60具(男33、女27)身长自52-128cm,并经动脉灌注红色乳胶,所观测深部位保留完好,由作者直接解剖剥离,将胸腰段脊椎的椎板及骶中嵴两旁切除剪开硬脊膜,进行定点测定,用游标卡尺测量长度。结果如下:一、脊髓圆锥下极位置与推骨的关系,脊髓下极位置不仅在小儿与成人有区别,同令者也有一定的差异。脊髓圆锥下极的测定点,由于脊髓圆锥乃逐渐移行于内终丝,故用肉眼严格地确定其界限并非易事。本文以尾神经根丝离开脊髓的平面下缘作为内终丝上端,即脊髓圆锥下界。儿童脊髓下界的位置观测结果见表     

Observations on the caudal end of the spinal cord

The development of the structural pattern of the lower sacral and coccygeal segments of the spinal cord in human, rabbit and monkey embryos and fetuses has been studied. The changes observed in serial sections from above downward are outlined, beginning with typical sections through the lower sacral cord. Among the changes, other than diminution in size of the spinal cord and reduction in size of the lower spinal nerves, there is a gradual disappearance of the posterior funiculus. As this occurs the gray matter appears to spread dorsally and the central canal widens. The gray matter becomes reduced in size and the lateral funiculus extends farther dorsally. A little lower down, the gray matter of the alar plate is reduced further in size and there is corresponding enlargement of the central canal. This enlargement constitutes the terminal ventricle. The spinal cord rapidly becomes smaller as both the fibers and the gray matter are diminished. In some specimens, fibers decussate dorsal to the lower end of the terminal ventricle. Little remains of the lower end of the spinal cord except the ependymal wall of the central canal and the surrounding fiber bundles. The shape and size of the lower end of the central canal is subject to variations. In the lower part of the spinal cord a longitudinal bundle on each side is formed by fiber contributions from the anterior horn cells in the basal plates. This bundle contributes fibers to the fifth sacral and the first and second coccygeal nerves. It is designated the sacrococcygeal fasciculus.     

Anatomical relationship and positions of the lumbar and sacral segments of the spinal cord according to the vertebral bodies and the spinal roots

Segments of the spinal cord generally do not correspond to the respective vertebral level and there are many anatomical variations in terms of the segment and the level of vertebra. The aim of this study is to investigate the variations and levels of lumbar and sacral spinal cord segments with reference to the axilla of the T11, T12, and L1 spinal nerve roots and adjacent vertebrae. Morphometric measurements were made on 16 formalin fixed adult cadaveric spinal cords. We observed termination of the spinal cord between the axilla of the L1 and L2 spinal nerve roots in 15 specimens (93.8%). In all cadavers the emergence of the T11, T12, and the L1 spinal nerve roots was at the level of the lower one‐third of the same vertebral body. In 15 specimens (93.8%), the beginning of the lumbar spinal cord segment was found to be above the T11 spinal nerve root axilla and corresponded to the upper one‐third of the T11 vertebral body. The beginning of the sacral spinal cord segment occurred above the L1 spinal nerve root axilla and corresponded to the upper one‐third of the L1 vertebral body. The results of this study showed that when the conus medullaris is located at the L1–L2 level, the beginning of the lumbar spinal cord segment always corresponds to the body of T11 vertebra. This study provides detailed information about the correspondence of the spinal cord segments with reference to the axilla of the spinal nerve roots. Clin. Anat. 27:227–233, 2014. © 2013 Wiley Periodicals, Inc.     

Anophthalmia-plus syndrome: a clinical report and review of the literature

We describe a term male infant of healthy non-consanguineous parents, born with congenital malformations, including bilateral cleft palate and lip, mild microphthalmia with iris coloboma and glaucoma of the right eye, and blepharophimosis with severe microphthalmia of the left eye. Spine radiograph and MRI showed first sacral hemivertebra with spina bifida, and agenesis of the 2nd, 3rd, 4th, and 5th sacral vertebrae and coccyx. Spine MRI showed caudal tethering of spinal cord at L(3) level, filum terminalis lipoma and a syringomyelia. Brain ultrasound and MRI showed hypoplasia of corpus callosum with mild dilatation of the lateral ventricles. Orbital MRI showed bilateral microphthalmia-distorted small left eyeball with posteriorly located lens, and a split vitreous body in the right eye, suggestive of primary hyperplastic vitreous. The karyotype was normal. Summary of the findings in nine cases (our case and eight published cases) support the notion that anophthalmia-plus syndrome (APS) is a distinct syndrome. Gene locus of APS is yet to be identified.     

胎儿脊髓节段与脊柱位置关系的研究

目的 为研究个体发育年龄解剖学提供资料.方法 从胎儿背侧打开椎管,暴露脊髓,观察50例胎儿的脊髓节段与脊柱的位置关系.结果 各被观察脊髓节段下界的平均位置是:第4颈节平对第3颈椎(C_3);第8颈节平对第6～7颈椎间盘;第4胸节平对第3胸椎(T_3);第8胸节平对第7胸椎;第12胸节于对第10胸椎;第5腰节平对第12胸椎至第1腰椎间盘;脊髓末端在第2腰椎水平.结论 从胎儿到成人,脊髓下端的位置随着年龄的增长而逐渐上升.     

家兔前庭核与脊髓的联系——HRP法研究

将HRP注入家兔颈、胸或腰髓的一侧灰质内,追踪前庭四核内的逆行标记细胞和顺行标记终支。发现同侧外侧核内标记细胞数量甚多,且具有体部定位规律。内侧核及降核的尾段标记细胞也较多,内侧核者甚为密集,它们投射到双侧脊髓的颈、胸、腰段,对侧多于同侧,无体部定位关系。降核的头段及在此平面的内侧核内也有一定数量的标记细胞,也投射到颈、胸、腰髓,同侧为主,无体部定位关系。上核内只有极少量标记细胞,主要投射到对侧颈髓。顺行标记终支于降核、内侧核的见端小范围内及外侧核的尾端背面较为恒定,颈、腰注射例在降核和内侧核的尾端尤为密集。     

Morphologic features of the caudal neurosecretory system in the blueback herring, Pomolobus aestivalis

The caudal neurosecretory system of the blueback herring, Pomolobus aestivalis, captured in freshwater, was examined. Neurosecretory cells were identified readily in terminal spinal cord segments. The axonal processes of these neurosecretory cells formed a discrete, ventrally placed bundle which terminated in a conspicuous ventral enlargement from the filum terminale. This enlargement comprises the neurohaemal contact zone or urophysis. The neurosecretory terminals were engorged with secretory granules in these fishes from a freshwater environment. The non-neuronal component of the urophysis also was examined in this study. These glial cells were dispersed throughout the urophysis. Most often they were found ensheathing the terminal neurosecretory processes. These cells showed a resemblance to neurohypophysial pituicytes. Although mentioned in the literature, these glial cells have not been examined with the electron microscope. The ultrastructural features of the glial cells and their relation to the neurosecretory constituents are described in this report.     

The diameter of the vertebral canal in dogs in cases of lumbosacral transitional vertebrae or numerical vertebral variations

From Th1 to L7 midsagittal and interpedicular vertebral canal diameters were measured in macerated spines of 162 dogs to determine, whether the presence of lumbosacral transitional vertebrae or numerical vertebral variations are associated with dislocation of the maximal enlargement of the lumbar vertebral canal. Relative to dogs with a regular number of 27 presacral vertebrae (C7/Th13/L7), the maximal enlargement of the lumbar vertebral canal was more frequently ( P < 0.05) located at vertebra 24 in dogs with 26 presacral vertebrae (C7/Th13/L6), and more frequently at vertebra 25 in dogs with 28 presacral vertebrae (C7/Th13/L8). However, in dogs with 26 presacral vertebrae, maximal agreement in the spinal position of maximal lumbar vertebral canal diameters was achieved relative to dogs with 28 presacral vertebrae by adding one additional thoracic (Th6, 7, or 8) segment. Therefore, the present findings strongly suggest that relative to the regular (C7/Th13/L7) condition, decrease in the number of presacral vertebrae (C7/Th13/L6) is associated with incorporation of a midthoracic segment, whereas increase in the number of presacral vertebrae (C7/Th13/L8) is not related to the presence of an additional vertebral segment. When using Th1 as landmark, the difference in the position of the maximal enlargement of the lumbar vertebral canal between dogs with 26 and dogs with 28 presacral vertebrae in average was only one segment. It is known from previous reports that the maximal enlargement of the lumbar vertebral canal corresponds with the maximal enlargement of the lumbar spinal cord. When using S1 or the transitional vertebra as the landmark for determination of the appropriate site for subarachnoid cannulation, this site is expected to range within the same limits regardless of the vertebral formula.     

Prediction Algorithm of the Cat Spinal Segments Lengths and Positions in Relation to the Vertebrae

Detailed knowledge of the topographic organization and precise access to the spinal cord segments is crucial for the neurosurgical manipulations as well as in vivo neurophysiological investigations of the spinal networks involved in sensorimotor and visceral functions. Because of high individual variability, accurate identification of particular portion of the lumbosacral enlargement is normally possible only during postmortem dissection. Yet, it is often necessary to determine the precise location of spinal segments prior to in vivo investigation, targeting spinal cord manipulations, neurointerface implantations, and neuronal activity recordings. To solve this problem, we have developed an algorithm to predict spinal segments locations based on their relation to vertebral reference points. The lengths and relative positions of the spinal cord segments (T13-S3) and the vertebrae (VT13-VL7) were measured in 17 adult cats. On the basis of these measurements, we elaborated the estimation procedure: the cubic regression of the ratio of the segment's length to the lengths of the VL2 vertebra was used for the determination of segment's length; and the quadratic regression of the ratio of their positions in relation to the VL2 rostral part was used to determine the position of the segments. The coefficients of these regressions were calculated at the training sample (nine cats) and were then confirmed at the testing sample (eight cats). Although the quality of the prediction is decreased in the caudal direction, we found high correlations between the regressions and real data. The proposed algorithm can be further translated to other species including human. Anat Rec, 302:1628–1637, 2019. © 2018 American Association for Anatomy     

犬马尾与骶神经根的解剖学观察

目的：为从马尾和骶神经根途径开展犬的神经泌尿学研究提供解剖依据。方法：对3只犬灌后进行解剖,并对22只犬进行术中观察,总结马尾、骶神经根的解剖特征。结果：犬的盆底器官由S1～S2脊髓节段和神经根支配;脊髓圆锥延续较长,达L6椎体下缘,而马尾神经较短;髓神经前后根出硬膜后,有各自独立的硬膜囊包绕直至后根神经节处,长1～1.5cm。结论：犬马尾和骶神经根的解剖特征与人类不同。     

Genetic spina bifida occulta in the mouse

Spina bifida occulta is one of the major effects of the recessive mutant “snubnose” (symbol sno). Linkage tests have located this mutant in chromosome 4. Defective spinal arch formation typically includes the lumbar and often the posterior thoracic and sacral vertebrae. There is great variation in detail, from nearly normal closure to a trough-like spinal column. Causes of the variation are not understood. Severely affected specimens may also have defective anterior thoracic vertebrae and reduced size of the sacral vertebrae, with kyphosis. The tail is essentially normal. No external lesion or myelomeningocele has been found, but there have been some instances of paralysis of the hind limbs, possibly from injury. The spinal cord seems normal as a rule, and pigmentation is normal. Embryological study has not been attempted, but the condition seems to be primarily osteogenic in origin.