臂丛神经椎间孔处的显微解剖及其临床意义

研究臂丛神经根及所属交感神经结构。方法：对１５具３０侧尸体观察了臂丛神经根及所属交感神经结构。结果：（１）椎管内臂丛神经根结构脆弱。暴力作用容易损伤，且无残存臂丛神经根可供直接修复。（２）臂丛各神经根分出角与其前支分出角的差异，可能为臂丛不同损伤类型的形态学基础。（３）Ｃ５、Ｃ６后支容易受骨赘或腱性组织卡压引起颈痛。（４）Ｈｏｍｅｒ征虽可作为诊断臂丛下干根性撕脱伤的一种依据，但星状神经节和下交通支由于缺乏肌肉筋膜保护，在暴力作用下可能单独损伤，导致诊断的假阳性。结论：熟悉臂丛神经椎间孔处的显微解剖有助于临床对臂丛的诊治。

Microsurgical anatomy of brachial plexus at the intervertebral foramen

Fifteen cadavers were used to observe the anatomy of brachial plexus nerve roots and their sympathetic nerve compooents . The results suggested : ( 1 ) The brachial plexus nerve roots were weak in the vertebral canal, liable to be iniured without repairable stumps. ( 2 ) The difference of the angle of the nerve roots and their anterior branches may be the morphological basis for different trauma patterns of brachial plexus . ( 3 ) The poaterior branches of C5 and C6 were easy to be comprosed by bony process or tedinous tissues and result- ed in neck pain. (4)Homer sign could support the diagnosis of brachial plexus lower trunk roots avulsion. However, the asteroid ganglion and inferior communicat ing branch lack the protection of musclo and fascia , they ould be injured independently . The Homer sign could be false positive.