Maigne J Y, Lazareth J P, Maigne R
Service de Rééducation Fonctionnelle et de Médecine Orthopédique, Hôtel-Dieu, Paris.
Rev Rhum Mal Osteoartic. 1988 Feb;55(2):107-11.
30 dissections have confirmed that the skin of the gluteal area is innervated by the posterior branches of T12 and L1, 19 times out of 30 (64 p. cent) or T12, L1 and L2, in 8 instances (26 p. cent) or T12, L1 and L2 receiving an anastomosis from L3, in 3 instances. This explains certain lumbo-gluteal pain coming from the dorso-lumbar area ("low lumbalgias of high origin"). In addition, the posterior branch, the most medial (most of the time L1, sometimes L2) goes through an osteo-aponeurotic channel formed by the iliac crest below and the dorso-lumbar fascia above. This channel, located at 7 or 8 cm of the spinal process, may be at the origin of a neuropathy. It projects at the same level in relation to the mid-line as the iliac insertion of the ilio-lumbar ligament. The latter seems impossible to feel as it is too deep and hidden by the superficial aspect of the iliac crest. Lumbalgias, sometimes related to a strain of this ligament, seem to be, most of the time, the result of an irritation of the posterior branch of L1 or L2.
30例解剖证实，臀区皮肤由T12和L1的后支支配，30例中有19例（64%）如此，8例（26%）由T12、L1和L2支配，3例由T12、L1和L2接受来自L3的吻合支支配。这解释了某些源于背腰部区域的腰臀痛（“高位腰椎痛”）。此外，最内侧的后支（多数情况下为L1，有时为L2）穿过由下方的髂嵴和上方的背腰筋膜形成的骨腱膜通道。该通道位于距棘突7或8厘米处，可能是神经病变的起源。它在与腰髂韧带髂部附着点相同的中线水平处穿出。由于其位置太深且被髂嵴的浅表部分遮盖，似乎无法触及该韧带。有时与该韧带劳损相关的腰痛，多数情况下似乎是L1或L2后支受刺激的结果。
