Gandhi K R, Verma V K, Chavan S K, Joshi S D, Joshi S S
Rural Medical College, Pravara Institue of Medical Sciences Loni, Maharashtra.
Folia Morphol (Warsz). 2013 Aug;72(3):217-22. doi: 10.5603/fm.2013.0036.
The vasospastic diseases and chronic pain related to lower limb have been successfully treated by surgical ablation of lumbar sympathetic trunk for last 80 years.Precise knowledge of anatomy of lumbar sympathetic trunk and its adjoining structures is mandatory for safe and uncomplicated lumbar and spinal surgeries.We aim to study the detailed anatomy of entry and exit of lumbar sympathetic trunk, the number, dimensions and location of lumbar ganglia in relation to lumbar vertebra. Thorough dissection was carried out in 30 formalin embalmed cadavers available in the Department of Anatomy, Pravara Institute of Medical Sciences (PIMS), Rural Medical College (RMC), Loni, Maharashtra. A total of 238 ganglia were observed in 60 lumbar sympathetic trunks. The sympathetic trunk traversed dorsal to the crus of diaphragm in 72.6% and in 13.3% it entered dorsal to the medial arcuate ligament. The most common site of the location of lumbar ganglia was in relation to the second lumbar vertebra, sometimes extending up to the L2-L3 vertebral disc. There was a medial shift of sympathetic trunk in lumbar region and it coursed over sacral promontory to reach the pelvic region in 96% of specimens. These variations should be kept in mind in order to prevent hazardous complications like accidental avulsion of first lumbar ganglia and genitofemoral neuritis.
在过去的80年里，通过手术切除腰交感干成功治疗了与下肢相关的血管痉挛性疾病和慢性疼痛。对于安全且无并发症的腰椎和脊柱手术而言，准确了解腰交感干及其毗邻结构的解剖知识是必不可少的。我们旨在研究腰交感干的出入详细解剖结构、腰神经节相对于腰椎的数量、大小和位置。在普拉瓦拉医学科学研究所（PIMS）、农村医学院（RMC）解剖学系提供的30具用福尔马林防腐的尸体上进行了详细解剖，这些尸体位于马哈拉施特拉邦洛尼。在60条腰交感干中总共观察到238个神经节。72.6%的交感干在膈脚背侧穿过，13.3%的交感干在内侧弓状韧带背侧进入。腰神经节最常见位置与第二腰椎相关，有时延伸至L2-L3椎间盘。在96%的标本中，交感干在腰部向内侧移位，并越过骶岬到达盆腔区域。为防止出现如第一腰神经节意外撕脱和生殖股神经炎等危险并发症，应牢记这些变异情况。
