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神经根的椎管内硬膜内变异。

Intraspinal intradural variations of nerve roots.

作者信息

Matejčík Viktor, Haviarová Zora, Šteňo Andrej, Kuruc Roman, Šteňo Juraj

机构信息

Department of Neurosurgery, Faculty of Medicine, University Hospital, Comenius University, Limbová 5, 833 05, Bratislava, Slovak Republic.

Faculty of Medicine, Institute of Anatomy, Comenius University, Sasinkova 2, 81372, Bratislava, Slovak Republic.

出版信息

Surg Radiol Anat. 2017 Dec;39(12):1385-1395. doi: 10.1007/s00276-017-1903-2. Epub 2017 Jul 29.

Abstract

PURPOSE

The aim of this work is to point out the intraspinal anatomical variations of nerve roots and their possible participation in radiculopathy.

METHODS

The anatomical study was performed in 33 cadavers. There were 25 male cadavers aged 30-75 years and 8 female cadavers aged 45-77 years, with a mean age of 46.5 years to 24 h from death. All intradural rami communicantes between nerve roots were excised and examined histologically for the presence or absence of nervous tissue. The type of the plexus was defined by subtracting from the root C2.

RESULTS

Findings of the normotype of plexus formation occurred in 24 cases (72.7%). Variations in its formation were observed in nine cases (27.3%). The prefixed type was observed in six cases (18.2%), postfixed type in three cases (9.1%). The formation of isolated prefixed or postfixed type of the brachial and lumbosacral plexus was not observed. Anatomical preparations revealed intradural variations in all cases of the lumbosacral plexus, 22 times (66.7%) in cases of cervical roots, and in the thoracic region seven times (21.2%). Variations occurred more frequently in variations of plexus formation.

CONCLUSIONS

This study allowed us to identify and describe unpublished intraspinal intradural anatomical variations of nerve roots, and their interrelationships throughout the spinal canal with their potential influence on the clinical picture. Anatomical preparations revealed a higher incidence of intraspinal intradural variations, particularly between sacral roots. Reliance of their incidence of the plexus type was observed.

摘要

目的

本研究旨在指出神经根的椎管内解剖变异及其在神经根病中可能的作用。

方法

对33具尸体进行解剖学研究。其中男性尸体25具,年龄30 - 75岁;女性尸体8具,年龄45 - 77岁,平均年龄46.5岁,死亡时间均在24小时内。切除所有神经根之间的硬脊膜交通支,并进行组织学检查以确定是否存在神经组织。通过从C2神经根开始计算来确定神经丛的类型。

结果

神经丛形成的正常类型在24例(72.7%)中出现。9例(27.3%)观察到其形成存在变异。6例(18.2%)观察到前置型,3例(9.1%)观察到后置型。未观察到孤立的前置或后置型臂丛和腰骶丛的形成。解剖标本显示,腰骶丛的所有病例均存在硬脊膜内变异,颈神经根病例中出现22次(66.7%),胸段出现7次(21.2%)。变异在神经丛形成变异中更频繁出现。

结论

本研究使我们能够识别和描述未发表的神经根椎管内硬脊膜内解剖变异,以及它们在整个椎管内的相互关系及其对临床表现的潜在影响。解剖标本显示椎管内硬脊膜内变异的发生率较高,尤其是在骶神经根之间。观察到其发生率与神经丛类型有关。

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