腰椎横突与第三腰椎横突综合征的相关性研究

目的：为探讨第三腰椎横突综合征提供解剖学依据。方法：对20套正常成年男性干燥腰椎骨横突长、宽、厚、横突间距及横突间夹角等进行了测量,同时对5具成年男尸的腰椎横突区进行了解剖观测。结果：①L3横突最长,L5横突宽及厚最大,横突长、宽、厚左右侧相比无显著性差异。横突间距亦以L5最大。横突间夹角在不同椎序间无显著性差异;②胸腰筋膜中层的纤维聚集成束附着于腰椎横突末端,在L3横突末端附着范围最大。每一横突间隙内有一恒定神经血管束从胸腰筋膜中层穿出,腰神经后外侧支被纤维束固定于横突背面。结论：①腰椎横突长度的解剖序列为L3〉L5〉L2〉L4〉L1;②L3横突最长,胸腰筋膜在L3横突末端附着范围最大,腰神经后外侧支被纤维束固定于横突背面等是导致L3横突综合征的解剖学基础。

Anatomical Research of the Transverse Process of Lumbar Vertebrae & the Third Lumbar Transverse Process Syndrome

Objective：To provide anatomical basis for the study of the third lumbar transverse process syndrome.Methods：The lengths,widths and thicknesses of transverse processes were measured on 20 sets of normal adult male dry lumbar vertebrae specimens.The distances and angles between two transverse processes,and the regions of lumbar transverse process on 5 adult male cadaveric specimens were measured.Results：①The length of the L3 transverse process was the longest,the width and thickness of the L5 transverse process was the biggest.There was no significant difference between the left and right in the length,width and thickness of the transverse process.The distance between two L5 transverse processes was the biggest.The angle between two transverse processes had no significant difference in different vertebrae;②In the middle layer of thoraco lumbar fascia,fibrous tracts stick to the end of transverse processes,which is more obvious over the L3 than others,a neural vascular bundle emerged from intertransverse process space,and the dorsal lateral lumbar nerves were fixed in the posterior transverse processes.Conclusions：①The order of the lengths of lumbar transverse processes is： L3〉L5〉L2〉L4〉L1.;②The third lumbar transverse process is too long,and its fibrous tracts stick to the end of transverse processes.Dorsal lateral lumbar nerves are fixed in the posterior transverse process.All these result in the third lumbar transverse process syndrome.