Rimmer C T, Adds P J
St George's, University of London, Cranmer Terrace, SW17 0RE London, United Kingdom.
Folia Morphol (Warsz). 2018;77(4):748-751. doi: 10.5603/FM.a2018.0024. Epub 2018 Mar 23.
The existence of posterior epidural ligaments (PEL) has been established in the lumbar region, but they have hitherto not been shown to exist in the thoracic vertebral column. Their identification is of clinical significance in respect to incidental durotomy and the circulation of cerebrospinal fluid (CSF). Fourteen thoracic spine sections were dissected by cutting through the intervertebral disc and separating the ligamentum flavum from the vertebra above. The dural sheath was gently retracted anteriorly to identify macroscopic connections between the ligamentum flavum and the dura. Macroscopic connections observed were dissected out, retaining some dural sheath and ligamentum flavum. Histological staining with haematoxylin and eosin and Miller's elastin stain was used to investigate cellular connections. Thoracic PELs were positively identified in 5 of the 14 cadavers (35.7%). Histology showed similarities between the thoracic and lumbar PELs. Fifteen separate PELs were identified within these five thoracic sections. The thoracic PEL has sufficient tensile strength to present a risk to the integrity of the dural sheath during surgery, and surgeons should be aware of these connections when operating on the thoracic spine. PELs may also contribute to the circulation of CSF in the spinal subarachnoid space.
后纵韧带（PEL）在腰椎区域的存在已得到证实，但迄今为止尚未在胸椎中发现其存在。它们的识别对于意外硬膜切开术和脑脊液（CSF）循环具有临床意义。通过切割椎间盘并将黄韧带与上方椎体分离，对14个胸椎节段进行解剖。将硬膜鞘轻轻向前牵拉，以识别黄韧带与硬膜之间的宏观连接。观察到的宏观连接被分离出来，保留一些硬膜鞘和黄韧带。使用苏木精和伊红染色以及米勒弹性蛋白染色进行组织学染色，以研究细胞连接。在14具尸体中的5具（35.7%）中阳性识别出胸椎PEL。组织学显示胸椎和腰椎PEL之间存在相似性。在这五个胸椎节段中识别出15条独立的PEL。胸椎PEL具有足够的拉伸强度，在手术期间对硬膜鞘的完整性构成风险，手术医生在对胸椎进行手术时应注意这些连接。PEL也可能有助于脊髓蛛网膜下腔中CSF的循环。
