Lu J, Ebraheim N A, Huntoon M, Heck B E, Yeasting R A
Department of Orthopaedic Surgery, Medical College of Ohio, Toledo 43614, USA.
Clin Orthop Relat Res. 1998 Feb(347):224-8.
No previous studies describe the anatomic relationship of the superior cluneal nerve to the posterior iliac crest and thoracolumbar fascia. In the current study, 15 cadavers were dissected to determine the relationship of the superior cluneal nerve to the posterior iliac crest and thoracolumbar fascia. The distances from the medial branch of the superior cluneal nerve to the posterior superior iliac crest and the midline were 64.7 +/- 5.3 mm and 81.0 +/- 9.2 mm, respectively. The distances between the level of the iliac crest and perforating points of the superior cluneal nerve on the thoracolumbar fascia were 5.8 +/- 1.8 mm inferiorly for the medial branch, 2.2 +/- 1.8 mm superiorly for the intermediate branch, and 12.0 +/- 4.4 mm superiorly for the lateral branch, respectively. The proximal dissection above the perforating point of the nerve showed that the medial branch of the superior cluneal nerve is confined within a tunnel consisting of the thoracolumbar fascia and the superior rim of the iliac crest as it passes over the iliac crest. The intermediate and lateral branches of the superior cluneal nerve either pierce the thoracolumbar fascia or pass through an orifice or fissure in the thoracolumbar fascia. In two specimens, the medial branches of the superior cluneal nerve were constricted within the osteofibrous tunnel. The nerve was entrapped between the rigid fibers of the thoracolumbar fascia and the iliac crest.
以往没有研究描述臀上皮神经与髂嵴后缘及胸腰筋膜的解剖关系。在本研究中，解剖了15具尸体以确定臀上皮神经与髂嵴后缘及胸腰筋膜的关系。臀上皮神经内侧支至髂后上棘和中线的距离分别为64.7±5.3mm和81.0±9.2mm。臀上皮神经内侧支、中间支和外侧支在胸腰筋膜上的穿入点与髂嵴水平之间的距离分别为下方5.8±1.8mm、上方2.2±1.8mm和上方12.0±4.4mm。在神经穿入点上方进行近端解剖显示，臀上皮神经内侧支在越过髂嵴时被限制在由胸腰筋膜和髂嵴上缘组成的通道内。臀上皮神经中间支和外侧支要么穿过胸腰筋膜，要么通过胸腰筋膜上的孔或裂隙。在两个标本中，臀上皮神经内侧支在骨纤维通道内受压。神经被困在胸腰筋膜的坚硬纤维和髂嵴之间。
