Maigne J Y, Maigne R
Department of Physical Medicine and Rehabilitation, Hôtel-Dieu Hospital, Paris, France.
Arch Phys Med Rehabil. 1991 Sep;72(10):734-7.
A trigger point is frequently found over the iliac crest at 7 to 8 cm from the midline in low-back-pain syndromes. Previously, this was described as either a painful insertion site of the iliolumbar ligament or pain in the distribution of the cutaneous dorsal ramus of the first or second lumbar nerve. The authors performed 37 dissections, and they report their anatomic findings. The iliac insertion of the iliolumbar ligament is inaccessible to palpation, being shielded by the iliac crest. The dorsal rami of L1 or L2 nerve roots, however, cross the crest at 7 cm from the midline, and this distance closely correlates with the dorsal projection of the iliolumbar ligament insertion. These rami are superficial and dorsal to the crest, easily accessible to palpation. In two of the 37 dissections performed, some rami were found to be narrowed as they crossed through an osteofibrous orifice over the crest, thus being susceptible to an entrapment neuropathy. The authors conclude that the trigger point sometimes localized over the iliac crest at 7 cm from the midline likely corresponds to elicited pain from a cutaneous dorsal ramus originating from the thoracolumbar junction rather than from the iliac insertion of the iliolumbar ligament.
在腰背痛综合征中，常可在距中线7至8厘米处的髂嵴上发现触发点。此前，这被描述为髂腰韧带的疼痛性附着点或第一或第二腰神经皮支分布区域的疼痛。作者进行了37次解剖，并报告了他们的解剖学发现。髂腰韧带在髂嵴的附着点无法触及，被髂嵴遮挡。然而，L1或L2神经根的后支在距中线7厘米处越过髂嵴，且该距离与髂腰韧带附着点的背侧投影密切相关。这些后支在髂嵴的浅面和背侧，易于触及。在进行的37次解剖中有2次发现，一些后支在穿过髂嵴上方的骨纤维孔时变窄，因此易患卡压性神经病变。作者得出结论，有时位于距中线7厘米处髂嵴上的触发点可能对应于来自胸腰交界处的皮支后支引起的疼痛，而非髂腰韧带在髂嵴的附着点处的疼痛。
