髋关节的感觉神经支配——一项解剖学研究。

The sensory innervation of the hip joint--an anatomical study.

作者信息

Birnbaum K, Prescher A, Hessler S, Heller K D

机构信息

Orthopaedic Department, Technical University Aachen, Germany.

出版信息

Surg Radiol Anat. 1997;19(6):371-5. doi: 10.1007/BF01628504.

Abstract

Typically obturator nerve blockade is used to relieve hip pain. It sometimes only has a minor effect in resolving symptoms. This clinical observation led us to examine comprehensively the sensory nerve innervation of formalin-fixed hip joint capsules. Following macroscopic preparation, the area of the hip joint capsule was inspected with the aid of an operating microscope. We discovered a separation between the anterior and posterior sensory innervation of the hip joint capsule. The anteromedial innervation was determined by the articular branches of the obturator n. Additionally, the anterior hip joint capsule was innervated by sensory articular branches from the femoral n. In the posterior part we found articular branches from the sciatic n., which in addition to the articular branches from the nerves to the quadratus femoris m., innervate the postero-medial section of the hip joint capsule. Moreover, articular branches of the superior gluteal n. were found, which innervate the posterolateral section of the hip joint capsule. This anatomical study demonstrates that the obturator n. block is insufficient for the treatment of hip pain. Further investigations will determine if these nn. can be reached percutaneously. Effective neural blockade of the hip joint must include the femoral n., the sciatic n. and the superior gluteal n.

摘要

通常,闭孔神经阻滞用于缓解髋部疼痛。它有时在缓解症状方面效果甚微。这一临床观察促使我们全面研究福尔马林固定的髋关节囊的感觉神经支配情况。在进行宏观制备后,借助手术显微镜检查髋关节囊区域。我们发现髋关节囊的前侧和后侧感觉神经支配存在分离。前内侧神经支配由闭孔神经的关节支决定。此外,髋关节囊前部由股神经的感觉关节支支配。在后部,我们发现坐骨神经的关节支,其除了来自支配股方肌神经的关节支外,还支配髋关节囊的后内侧部分。此外,还发现了臀上神经的关节支,其支配髋关节囊的后外侧部分。这项解剖学研究表明,闭孔神经阻滞对于髋部疼痛的治疗是不够的。进一步的研究将确定这些神经是否可以通过经皮方式触及。有效的髋关节神经阻滞必须包括股神经、坐骨神经和臀上神经。

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