生殖股神经（GFN）腰大肌内段的应用解剖及临床意义

发布时间：2018-12-13 22:04

【摘要】：目的：通过尸体应用解剖了解GFN腰大肌内段的形态学特点，为腰椎前路手术中避免或减少GFN损伤提供解剖学依据。方法：选择15例成年男性尸体标本，仔细分离腰大肌，研究GFN在腰大肌内的行径及分支形态特点，选择术中易于触及的骨性结构或突起作为标志，测量数据，进行统计学处理。结果：GFN腰大肌内段可分为三种类型：Ⅰ型：GFN单独由L1神经根发出后斜向前内下方穿越腰大肌，在L3、4椎间盘上方经腰大肌前筋膜穿出，占20％(6／30)。Ⅱ型：L1发出的神经干与L2发出的神经干汇合后发出GFN向前内下方穿越腰大肌，少数(6／17)在L3、4椎间盘上方经腰大肌前筋膜穿出，多数(11／17)在L3、4椎问盘下方经腰大肌前筋膜穿出，占56.7％(17／30)。Ⅲ型：L1发出的神经干与L2发出的神经干汇合后发出的GFN从发出点分为生殖支和股支。生殖支向前内下方穿越腰大肌在L3、4椎间盘上或下方经腰大肌前筋膜穿出，股支多由腰大肌中间穿出，占23.3％(7／30)。GFN腰大肌内段的长度测量结果为左侧4.850±0.788cm，右侧4.533±0.851cm，p＞0.05。结论：在显露L2-L4椎体侧方时容易损伤GFN，分开腰大肌显露L2-L4椎体侧方应注意避免损伤斜向前内下穿越的GFN。在注意保护GFN前提下，，分开腰大肌显露腰椎可减少大血管、输尿管、交感神经损伤等并发症。
[Abstract]:Objective: to investigate the morphologic features of the internal segment of GFN's psoas major muscle by using cadaveric anatomy to provide anatomic basis for avoiding or reducing GFN injury in anterior lumbar spine surgery. Methods: 15 adult male cadavers were selected to carefully separate the psoas major muscle. The behavior and branching morphological characteristics of GFN in the psoas major muscle were studied. The osseous structure or protrusions which were easily accessible during the operation were selected as markers, and the data were measured and analyzed statistically. Results: there were three types of GFN psoas major muscle: type 鈪

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