Geers Caroline, Lecouvet Frédéric E, Behets Catherine, Malghem Jacques, Cosnard Guy, Lengelé Benoît G
Human Anatomy Research Unit, St. Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium.
AJNR Am J Neuroradiol. 2003 Aug;24(7):1276-82.
In patients with epidural lipomatosis, axial lumbar spine CT and MR images occasionally reveal a geometric, polygonal or stellar, shape of the dural sac. The purpose of this study was to define the anatomic structures responsible for this radiologic appearance. We hypothesized that meningovertebral ligaments could anchor the dura mater to the osteofibrous walls of the spinal canal and account for the geometric deformation of the dural sac.
The epidural spaces were examined in 15 adult cadaveric and seven aborted fetal lumbar spines. For macroscopic studies, 70 adult vertebral segments were separated and dissected by removing the extradural fat. For microscopic examination, axial histologic sections were obtained from 35 fetal and five adult undissected vertebral segments.
Meningovertebral ligaments were observed in the median, paramedian, and lateral aspects of the anterior and posterior epidural spaces of both adult and fetal lumbar spines. These ligaments anchor the outer surface of the dura mater to the osteofibrous walls of the lumbar canal. They may form an irregular longitudinal septum partitioning the epidural space. Histologic examination demonstrated the fibroelastic composition of these ligaments and suggested their possible perivascular morphogenetic origin.
The morphologic and topographic features of the meningovertebral ligaments explain the polygonal, stellar, or Y-shaped deformation of the dural sac observed on axial CT and MR images in patients with lumbar epidural lipomatosis.
在硬膜外脂肪增多症患者中，腰椎轴位CT和MR图像偶尔会显示硬膜囊呈几何形状、多边形或星状。本研究的目的是确定导致这种影像学表现的解剖结构。我们推测脊膜椎韧带可将硬脑膜固定于椎管的骨纤维壁，并解释硬膜囊的几何变形。
对15具成人尸体和7例流产胎儿的腰椎硬膜外间隙进行检查。对于宏观研究，分离并解剖70个成人椎体节段，去除硬膜外脂肪。对于微观检查，从35个胎儿和5个未解剖的成人椎体节段获取轴位组织切片。
在成人和胎儿腰椎的前、后硬膜外间隙的正中、旁正中及外侧均观察到脊膜椎韧带。这些韧带将硬脑膜的外表面固定于腰椎管的骨纤维壁。它们可能形成一个不规则的纵向间隔，将硬膜外间隙分隔开。组织学检查显示这些韧带的纤维弹性成分，并提示其可能的血管周围形态发生起源。
脊膜椎韧带的形态和局部解剖特征解释了腰椎硬膜外脂肪增多症患者轴位CT和MR图像上观察到的硬膜囊多边形、星状或Y形变形。
