Griffith University School of Medicine, Gold Coast, Queensland, Australia.
Greenslopes Private Hospital, Greenslopes, Queensland, Australia.
Int J Gynaecol Obstet. 2023 Sep;162(3):842-846. doi: 10.1002/ijgo.14751. Epub 2023 Mar 20.
Apical support is an important component of pelvic floor reconstruction for pelvic organ prolapse. Sacrospinous ligament fixation is a recognized procedure for apical support. Complications from sacrospinous ligament fixation include pain (buttock and leg) and bleeding. There is some debate as to the optimal location for placement of the sacrospinous fixation sutures. This review summarizes the neuroanatomy of the coccygeus sacrospinous ligament as it pertains to the sacrospinous ligament fixation procedure. An appreciation of the neuroanatomy will lead to a better understanding of methods to reduce operative complications and improve suture placement. This paper also describes a technique for the sacrospinous fixation procedure to better assist clinicians in dissecting the connective tissue off the ligament. Removing or clearing the connective tissue off the ligament will allow critical landmarks to be easily palpated and hence a more accurate placement of sutures. This in turn may reduce the risk of perioperative complications.
肛提肌支持是盆腔器官脱垂行盆底重建的重要组成部分。骶棘韧带固定术是公认的用于肛提肌支持的术式。骶棘韧带固定术的并发症包括疼痛（臀部和腿部）和出血。骶棘固定缝线的最佳位置存在一定争议。本文总结了与骶棘韧带固定术相关的尾骨-骶棘韧带的神经解剖学。了解神经解剖学将有助于更好地理解减少手术并发症和改善缝线放置的方法。本文还描述了一种骶棘固定术的技术，以更好地帮助临床医生将韧带周围的结缔组织分离。清除韧带周围的结缔组织将使重要的解剖标志易于触诊，从而更准确地放置缝线。这反过来又可以降低围手术期并发症的风险。
