髋关节囊后份的神经支配:尸体研究。
Innervation of the Posterior Hip Capsule: A Cadaveric Study.
机构信息
Departments of Anesthesiology, UT Health San Antonio Joe R. & Theresa Lozano Long School of Medicine, San Antonio, Texas, USA.
Department of Cell Systems & Anatomy, UT Health San Antonio Joe R. & Theresa Lozano Long School of Medicine, San Antonio, Texas, USA.
出版信息
Pain Med. 2021 May 21;22(5):1072-1079. doi: 10.1093/pm/pnab057.
OBJECTIVE
Recent studies of hip anatomy have turned to the posterior hip capsule to better understand the anatomic location of the posterior capsular sensory branches and identify nerves with potential for neural blockade. Current literature has shown the posterior hip capsule is primarily supplied by branches from the sciatic nerve, nerve to quadratus femoris, and superior gluteal nerve (1, 2). This cadaveric study investigated the gross anatomy of the posterior hip, while also identifying potential targets for hip analgesia, with emphasis on the superior gluteal nerve and nerve to quadratus femoris.
DESIGN
Cadaveric study.
SETTING
UT Health San Antonio Anatomy Lab.
METHODS
In total, 10 total cadavers (18 hips total), were posteriorly dissected identifying nerve to quadratus femoris, superior gluteal nerve, and sciatic nerve. Nerves were labeled with radio-opaque markers. Following the dissections, fluoroscopic images were obtained at sequential angles to identify neural anatomy and help expand anatomic knowledge for interventional pain procedures.
RESULTS
The posterior hip capsule was supplied by the sciatic nerve in 1/16 hips, the nerve to quadratus femoris in 15/18 hips, and the superior gluteal nerve in 6/18 hips.
CONCLUSIONS
The nerve to quadratus femoris reliably innervates the posterior hip joint. Both the sciatic nerve and superior gluteal nerve have small articular branches that may be involved in posterior hip innervation, but this is not seen commonly. The results of this study may elucidate novel therapeutic targets for treatment of chronic refractory hip pain (i.e., the nerve to quadratus femoris).
目的
最近对髋关节解剖结构的研究转向了髋关节后囊,以更好地了解后囊感觉支的解剖位置,并确定具有神经阻滞潜力的神经。目前的文献表明,髋关节后囊主要由坐骨神经、股方肌神经和臀上神经的分支供应(1,2)。这项尸体研究调查了髋关节的大体解剖结构,同时确定了髋关节镇痛的潜在靶点,重点是臀上神经和股方肌神经。
设计
尸体研究。
地点
UT Health San Antonio 解剖实验室。
方法
总共对 10 具尸体(总共 18 个髋关节)进行了后部分离,以识别股方肌神经、臀上神经和坐骨神经。用放射性不透射线的标记物标记神经。解剖后,获取连续角度的荧光透视图像,以识别神经解剖结构,并帮助扩展介入性疼痛程序的解剖知识。
结果
髋关节后囊由 1/16 的髋关节中的坐骨神经、18 个髋关节中的 15 个由股方肌神经和 6 个髋关节中的臀上神经供应。
结论
股方肌神经可靠地支配髋关节后关节。坐骨神经和臀上神经都有小的关节支,可能参与髋关节的神经支配,但这种情况并不常见。本研究的结果可能阐明了治疗慢性难治性髋关节疼痛的新的治疗靶点(即股方肌神经)。