Department of Orthopedic Trauma Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China, 200003.
Sci Rep. 2019 Sep 30;9(1):13993. doi: 10.1038/s41598-019-50484-7.
Patients suffer bilateral sacral plexus injuries experience severe problems with incontinence. We performed a cadaveric study to explore the anatomical feasibility of transferring ipsilateral S2 nerve root combined with a sural nerve graft to pudendal nerve for restoration of external anal and urethral sphincter function. The sacral nerve roots and pudendal nerve roots on the right side were exposed in 10 cadavers. The length from S2 nerve root origin to pudendal nerve at inferior border of piriformis was measured. The sural nerve was used as nerve graft. The diameters and nerve cross-sectional areas of S2 nerve root, pudendal nerve and sural nerve were measured and calculated, so as the number of myelinated axons of three nerves on each cadaver specimen. The length from S2 nerve root to pudendal nerve was 10.69 ± 1.67 cm. The cross-sectional areas of the three nerves were 8.57 ± 3.03 mm for S2, 7.02 ± 2.04 mm for pudendal nerve and 6.33 ± 1.61 mm for sural nerve. The pudendal nerve contained approximately the same number of axons (5708 ± 1143) as the sural nerve (5607 ± 1305), which was a bit less than that of the S2 nerve root (6005 ± 1479). The S2 nerve root in combination with a sural nerve graft is surgically feasible to transfer to the pudendal nerve for return of external urethral and anal sphincter function, and may be suitable for clinical application in patients suffering from incontinence following sacral plexus injuries.
患者双侧骶丛损伤会出现严重的失禁问题。我们进行了一项尸体研究，探讨将同侧 S2 神经根与腓肠神经移植物转移至阴部神经以恢复外肛和尿道括约肌功能的解剖学可行性。在 10 具尸体中暴露右侧骶神经根和阴部神经根。测量 S2 神经根起点至梨状肌下缘阴部神经的长度。使用腓肠神经作为神经移植物。测量并计算 S2 神经根、阴部神经和腓肠神经的直径和神经横截面积，以及每个尸体标本上三条神经的有髓轴突数量。S2 神经根至阴部神经的长度为 10.69 ± 1.67cm。三条神经的横截面积分别为 S2 神经根 8.57 ± 3.03mm、阴部神经 7.02 ± 2.04mm 和腓肠神经 6.33 ± 1.61mm。阴部神经的轴突数量（5708 ± 1143）与腓肠神经大致相同（5607 ± 1305），略少于 S2 神经根（6005 ± 1479）。S2 神经根联合腓肠神经移植物转移至阴部神经恢复外尿道和肛门括约肌功能在手术上是可行的，可能适合用于治疗因骶丛损伤而导致失禁的患者。
