椎管内胸神经根移位至腰神经根的解剖学研究

目的 了解椎管内T9～12神经根移位修复L2～4神经根、恢复截瘫后股四头肌功能的解剖学基础.方法 5 具成人尸体标本,其中男性2具,女性3具.完全显露胸段及腰段椎管,观察T9～L4神经根在脊髓上发出的部位,T12及L1椎体水平与椎管内各神经根之间的关系;测量T9～L4神经根在椎管内的长度,T9～L4神经根的直径,T9～L4各神经根起始部之间的距离,T9～12神经根自硬脊膜穿出到L2椎体中部水平的距离.结果 T9神经根发自T9椎体中部,L4神经根发自L2椎体中部;T9～L4神经根在椎管内的长度均值分别为16.12、22.97、30.43、43.47、56.02、70.03、88.70和113.65mm.T9～L4神经根的直径均值分别为2.45、2.04、1.96、2.18、2.32、2.56、3.10和3.26 mm.各神经根起始部之间的距离均值分别为22.87、25.08、28.47、27.38、29.78、31.93和31.00 mm.T9～12神经根自硬脊膜穿出到L2椎体中部水平的距离均值分别为118.69、95.82、70.74和42.27 mm.结论 T9～12神经根均可以作为动力神经;可以将L2椎体的中部作为受体神经吻合平面修复L2～4神经根.

The anatomic study of transferring thoracic nerve roots to lumbar nerve root inside the spinal canal of paraplegia

Objective To study the fundamental anatomy of transferring T9-12 nerve roots to L2-4 nerve root for the quadriceps function recovery inside the spinal canal of paraplegia. Methods Thoracic and lumbar spinal canal and spinal dura mater of 5 adult cadavers (male 2 and female 3) were opened and explored. Investigated including: the position which T9 -L4 nerve root generated from spinal cord; the relation between the position which T9-L4 nerve root generated from spinal cord and T12 vertebrae and L1 vertebrae;The length beginning part of T9-L4 nerve root inside the spinal canal. The diameter of T9-L4 nerve root. The distance between the T9-L4 nerve root separately. The distance between the position which T9-12 nerve root separately generated from dura mater and the middle of L2 vertebrae. Results T9 nerve root generated from the middle part of T9 vertebrae; L4 nerve root generates from middle part of L2 vertebrae. The average length of T9-L4 nerve root inside the spinal canal separately was 16. 12, 22. 97, 30. 43, 43.47, 56. 02, 70. 03,88. 70 and 113.65 mm. The average diameter of T9 -L4 nerve root separately was 2. 45, 2. 04, 1.96, 2. 18,2. 32, 2. 56, 3. 10 and 3.26 mm. The average distance between the beginning part of T9-L4 nerve root separately was 22. 87, 25.08, 28.47, 27.38, 29.78, 31.93 and 31.00 mm. The average distance between the position which T9-12 nerve root separately generated from dura mater and the middle of L2 vertebrae was 118.69, 95.82, 70.74, and 42.27 mm. Conclusions T9-12 nerve root can be used as donor nerve for repair L2-4 nerve root. The level of L2 vertebrae can be anastomose site of the recipient nerve.