在皮肤逆行后柱固定过程中,坐骨神经的解剖位置是由部位置决定的
Marlon J Murasko1, Blake Nourie1, Michael R Cooley2
1Departments of Orthopaedic Surgery, and.
Journal of orthopaedic trauma
|October 11, 2023
概括
曲部增加了坐骨神经和坐骨之间的距离,减少了在骨骨折手术期间受伤的风险. 最安全的病人的位置是横或仰卧,部曲到90度.
科学领域:
- 整形外科手术 整形外科手术
- 人体解剖学 解剖学 解剖学
- 医学成像医学成像
背景情况:
- 穿皮逆行后列螺丝放置用于骨骨折,有伤害坐骨神经的风险.
- 坐骨神经在解剖学上位于坐骨管附近,这是螺丝的起点.
- 了解坐骨神经的位置变化对于手术安全至关重要.
研究的目的:
- 为了确定患者的部位置如何影响坐骨神经相对于坐骨结核的位置.
- 为了确定最佳的患者定位,以尽量减少脊髓神经在后列螺丝固定期间的风险.
主要方法:
- 在11名健康志愿者身上,超声波测量了脊椎结核与坐骨神经之间的距离.
- 测量时,部曲 (90度),模拟仰卧/侧卧位置,并延伸,模拟俯卧位置.
- 部绑架和旋转被保持在中立位置.
主要成果:
- 与部伸展相比,在部屈曲的位置上,石结节和坐骨神经之间的距离显著增加 (39毫米对比17毫米,P < 0.001).
- 所有受试者都表现出更大的坐骨神经远离坐骨,当部曲时.
结论:
- 部曲会导致显著的坐骨神经移位,远离坐骨结核.
- 侧侧或卧卧的患者定位与90度部曲是穿皮逆行后列螺丝放置最安全的方法.
- 这一发现有助于预防在骨骨折手术期间的坐骨神经中产性损伤.
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