Spencer D L, Irwin G S, Miller J A
Spine (Phila Pa 1976). 1983 Sep;8(6):672-9. doi: 10.1097/00007632-198309000-00014.
The anatomy of 54 pairs of lumbosacral nerve roots was described in nine fresh adult cadaver specimens, with particular attention given to the fixation of the nerve roots to surrounding skeletal and ligamentous structures in the lumbar spine. Dural ligaments were identified fixing the dura and nerve roots at their exit from the main dural sac to the posterior longitudinal ligament and vertebral body periosteum proximal to the intervertebral disc. Distal fixation occurs at the intervertebral foramen where the epineural sheath of the spinal nerve is attached. The overall arrangement is one which tends to hold the exiting nerve root anteriorly in the spinal canal. Mechanical analysis of this anatomical arrangement explains how pressure can be applied to the extrathecal nerve root by a disc protrusion without compression of the nerve root against the posterior elements. The possible role of the dural ligaments in the pathogenesis of the sciatica syndrome is discussed.
在9个新鲜成人尸体标本中描述了54对腰骶神经根的解剖结构，特别关注了神经根在腰椎处与周围骨骼和韧带结构的固定情况。确定了硬脊膜韧带，其在硬脊膜囊和神经根从主硬脊膜囊穿出至椎间盘近端的后纵韧带和椎体骨膜处固定硬脊膜和神经根。远端固定发生在椎间孔，此处脊神经的神经外膜鞘附着于此。整体排列倾向于将穿出的神经根向前固定在椎管内。对这种解剖结构的力学分析解释了椎间盘突出如何在不使神经根向后侧结构受压的情况下对鞘外神经根施加压力。讨论了硬脊膜韧带在坐骨神经痛综合征发病机制中的可能作用。
