骶丛主神经的节段形成

V. Novak, O. Bevz, A. Melnychenko, M. Ilnitsky, N. Prysyazhnyuk
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引用次数: 0

摘要

节段神经支配的研究可能具有实际意义,因为涉及器官和组织的病理过程可能由外周神经和单个节段神经的损伤引起。此外,骨盆肢体结构的病理状况的发生可能与各种损伤、脊髓、根和骶骨节段神经的损伤有关。实验研究的目的是研究猫骶丛主神经的节段形成——坐骨神经、胫骨神经、腓总神经。本研究对腰骶段L4、L5、L6、L7、S1、S2进行了单侧椎外神经节切除术。在偏振光下检查主神经样本,以在x400放大倍数下检测Wallerian变性的迹象。这种方法可以很容易地将不同退化阶段的退化神经纤维与正常神经纤维区分开来。变性初始阶段的微观形态特征是纤维不均匀增厚,兰维尔节平滑,Schmidt-Lanterman缺口扩张,髓鞘节段数量增加。在Wallerian变性的后期,观察到以下情况:髓鞘水肿和明显增厚,纤维轮廓平滑,卵球形形成和髓鞘碎片发光。使用Student t检验对结果进行统计分析。在研究过程中,发现在骶丛主要神经的形成过程中:坐骨神经、胫骨神经、腓骨总神经涉及腰骶棘的6个节段,从L4到S2。骶丛的这些神经是多节的,这表明它们具有代偿特性。骶丛主神经的退化神经纤维百分比最高的是第6腰段L6,它是轴神经。所获得的结果可以扩展解剖学中分割原理的知识,成为骶骨区域硬膜外麻醉用于骨盆四肢骨科手术、神经阻滞增加患者术后舒适度、腰椎穿刺、神经治疗的参考点。偏振显微镜方法可作为外周神经活检的临床有用测试,以评估神经退行性变化的状态,监测再生和神经保护作用。关键词:Wallerian变性,节段神经支配,骶丛,偏光显微镜,猫。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Segmental formation of the main nerves of the sacral plexus
The study of segmental innervation may be of practical interest, as pathological processes involving organs and tissues can be caused by damage to both peripheral and individual segmental nerves. Also, the occurrence of a pathological condition of the pelvic limb structures can be associated with various injuries, damage to the spinal cord, roots and segmental nerves of the sacral spine. The aim of the experimental research was to study the segmental formation of the main nerves of the sacral plexus – n. ischiadicus, n. tibialis, n. peroneus communis in cats. Unilateral extravertebral ganglioectomy of the lumbosacral segments – L 4, L5, L6, L7, S1, S2 was performed for the study. Samples of the main nerves were examined in polarized light to detect signs of Wallerian's degeneration at x400 magnification. This method allows you to easily distinguish degenerated nerve fibers at different stages of degeneration from normal. The micromorphology of the initial stages of degeneration is characterized by uneven thickening of the fibers, smoothing of the Ranvier nodes, dilated Schmidt-Lanterman notches, an increasein the number of myelin segments. At later stages of Wallerian's degeneration, the following are observed: edema and significant thickening of the myelin sheath, smoothing of fiber contours, formation of ovoids and fragmentary glow of myelin. Statistical analysis of the results was performed using Student's t-test. In the course of research, it was found that in the formation of the main nerves of the sacral plexus: n. ischiadicus, n. tibialis, n. peroneus communis involves 6 segments of the lumbosacral spine - from L4 to S2. These nerves of the sacral plexus are polysegmental, which indicates their compensatory properties. The highest percentage of degenerated nerve fibers for the main nerves of the sacral plexus gives the 6th lumbar segment L6, which is the axial nerve. The obtained results can expand the knowledge of principles of segmentation in anatomy, to become a reference point for sacral regional epidural anesthesia for orthopedic operations on the pelvic limbs, nerve blockade to increase patient comfort in the postoperative period, lumbar puncture, neurotherapy. The method of polarization microscopy can be used as a clinically useful test for peripheral nerve biopsy to assess the state of neurodegenerative changes, monitoring regenerative and neuroprotective effects. Key words: Wallerian degeneration, segmental innervation, sacral plexus, polarization microscopy, cats.
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