Tubbs R Shane, Khoury Charles A, Salter E George, Acakpo-Satchivi Leslie, Wellons John C, Blount Jeffrey P, Oakes W Jerry
Department of Cell Biology and School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35233, USA.
J Neurosurg. 2006 Dec;105(6):881-3. doi: 10.3171/jns.2006.105.6.881.
New information regarding nerve branches of the brachial plexus can be useful to the surgeon performing neurotization procedures following patient injury. Nerves in the vicinity of the axillae have been commonly used for neural grafting procedures, with the exception of the lower subscapular nerve (LSN).
The authors dissected and measured the LSN in 47 upper extremities (left and right sides) obtained in 27 adult cadavers, and determined distances between the LSN and surrounding nerves to help quantify it for possible use in neurotization procedures. The mean diameter of the LSN was 2.3 mm. The mean length of the LSN from its origin at the posterior cord until it branched to the subscapularis muscle was 3.5 cm, and the mean distance from this branch until its termination in the teres major muscle was 6 cm. Therefore, the mean length of the entire LSN from the posterior cord to the teres major was 9.5 cm. When the LSN was mobilized to explore its possible use in neurotization, it reached the entrance site of the musculocutaneous nerve into the coracobrachialis muscle in all but three sides and was within 1.5 cm from this point in these three. In the other specimens, the mean length of the LSN distal to this site of the musculocutaneous nerve was 2 cm. The mobilized LSN reached the axillary nerve trunk as it entered the quadrangular space in all specimens. The mean length of the LSN distal to this point on the axillary nerve was 2.5 cm. Furthermore, on all but one side the LSN was found within the confines of an anatomical triangle previously described by the authors.
The authors hope that these data will prove useful to the surgeon for both identifying the LSN and planning for potential neurotization procedures of the brachial plexus.
关于臂丛神经分支的新信息对外科医生在患者受伤后进行神经移植手术可能有用。除肩胛下神经（LSN）外，腋窝附近的神经通常用于神经移植手术。
作者解剖并测量了27具成年尸体的47个上肢（左右两侧）的LSN，并确定了LSN与周围神经之间的距离，以帮助对其进行量化，以便可能用于神经移植手术。LSN的平均直径为2.3毫米。LSN从后束起始直至分支至肩胛下肌的平均长度为3.5厘米，从该分支直至其在大圆肌中终止的平均距离为6厘米。因此，整个LSN从后束到大圆肌的平均长度为9.5厘米。当移动LSN以探索其在神经移植中的可能用途时，除了三个侧面外，它在所有侧面都到达了肌皮神经进入肱二头肌的入口点，并且在这三个侧面中距离该点1.5厘米以内。在其他标本中，肌皮神经该位点远端的LSN平均长度为2厘米。在所有标本中，移动的LSN在进入四边形间隙时到达腋神经干。腋神经上该点远端的LSN平均长度为2.5厘米。此外，除了一侧外，在作者先前描述的一个解剖三角形范围内均发现了LSN。
作者希望这些数据将被证明对外科医生识别LSN和规划臂丛神经潜在的神经移植手术有用。
