【摘要】：目的：通過尸體應(yīng)用解剖了解GFN腰大肌內(nèi)段的形態(tài)學(xué)特點(diǎn)，為腰椎前路手術(shù)中避免或減少GFN損傷提供解剖學(xué)依據(jù)。方法：選擇15例成年男性尸體標(biāo)本，仔細(xì)分離腰大肌，研究GFN在腰大肌內(nèi)的行徑及分支形態(tài)特點(diǎn)，選擇術(shù)中易于觸及的骨性結(jié)構(gòu)或突起作為標(biāo)志，測量數(shù)據(jù)，進(jìn)行統(tǒng)計(jì)學(xué)處理。結(jié)果：GFN腰大肌內(nèi)段可分為三種類型：Ⅰ型：GFN單獨(dú)由L1神經(jīng)根發(fā)出后斜向前內(nèi)下方穿越腰大肌，在L3、4椎間盤上方經(jīng)腰大肌前筋膜穿出，占20％(6／30)。Ⅱ型：L1發(fā)出的神經(jīng)干與L2發(fā)出的神經(jīng)干匯合后發(fā)出GFN向前內(nèi)下方穿越腰大肌，少數(shù)(6／17)在L3、4椎間盤上方經(jīng)腰大肌前筋膜穿出，多數(shù)(11／17)在L3、4椎問盤下方經(jīng)腰大肌前筋膜穿出，占56.7％(17／30)。Ⅲ型：L1發(fā)出的神經(jīng)干與L2發(fā)出的神經(jīng)干匯合后發(fā)出的GFN從發(fā)出點(diǎn)分為生殖支和股支。生殖支向前內(nèi)下方穿越腰大肌在L3、4椎間盤上或下方經(jīng)腰大肌前筋膜穿出，股支多由腰大肌中間穿出，占23.3％(7／30)。GFN腰大肌內(nèi)段的長度測量結(jié)果為左側(cè)4.850±0.788cm，右側(cè)4.533±0.851cm，p＞0.05。結(jié)論：在顯露L2-L4椎體側(cè)方時(shí)容易損傷GFN，分開腰大肌顯露L2-L4椎體側(cè)方應(yīng)注意避免損傷斜向前內(nèi)下穿越的GFN。在注意保護(hù)GFN前提下，，分開腰大肌顯露腰椎可減少大血管、輸尿管、交感神經(jīng)損傷等并發(fā)癥。
[Abstract]:Objective: to investigate the morphologic features of the internal segment of GFN's psoas major muscle by using cadaveric anatomy to provide anatomic basis for avoiding or reducing GFN injury in anterior lumbar spine surgery. Methods: 15 adult male cadavers were selected to carefully separate the psoas major muscle. The behavior and branching morphological characteristics of GFN in the psoas major muscle were studied. The osseous structure or protrusions which were easily accessible during the operation were selected as markers, and the data were measured and analyzed statistically. Results: there were three types of GFN psoas major muscle: type 鈪

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