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目的探索通过骶部骨性标志快速定位识别骶管裂孔,并阐明其与骶神经节和硬脊膜的位置关系,为从骶管裂孔进行骶管囊肿穿刺治疗的进针位置、角度和深度提供解剖学指导。方法取成人尸体标本15例。测量骶管裂孔到硬脊膜下界及骶神经节的距离,对骶角、骶管裂孔以及左右髂后上棘与骶角中点的位置关系进行了研究,对矢状切面进行了多种解剖学测量,记录穿刺针插入的角度和深度。结果两侧骶角中点到尾骨末端的平均距离为(5.73±0.81)cm,两侧髂后上棘与骶角中点构成等腰三角形,3条边的尺寸在女性偏小,从骶管裂孔进针的平均俯角是60.4°,两侧骶角中点到达硬脊膜下界的距离大于到达第3骶神经节中点的距离,小于到达第1、2骶神经节中点的距离。结论总结出骶管裂孔的体表定位方法,阐明了骶管裂孔在体表的准确位置、深度及其与骶神经节和硬脊膜的位置关系,骶管裂孔进针的最佳角度,这些测量研究结果可帮助临床医师对骶管囊肿进行更安全的诊断和治疗,也可为骶管麻醉、骶前后区射频神经切断术,以及超声检查提供有用的参考。
OBJECTIVE: To explore the location of caudal hiatus through the rapid localization of sacral bony markers and their relationship with sacral ganglia and dura mater to provide the location, angle and depth of needle insertion for caudal sac puncture from sacral hiatus Anatomy guidance. Methods Fifteen adult cadaver specimens were taken. The distance between the sacral fissure and the sacral ganglion was measured, and the relationship between the sacral angle, the sacral canal and the posterior superior iliac spine and the midpoint of the sacral angle was studied. The sagittal section was dissected Measure and record the angle and depth of the needle insertion. Results The average distance from the midpoint of sacral angle to the end of coccyx was (5.73 ± 0.81) cm. The posterior superior iliac spine and sacral angle midpoint formed isosceles triangles. The size of three sides was smaller in females than that in sacral canal The average depression angle of the hole was 60.4 °. The distance from the midpoint of the sacral angle to the subdural border was greater than the distance from the midpoint of the third sacral ganglion to the midpoint of the first sacral ganglion. Conclusions The body surface positioning method of sacral hiatus is summarized, and the exact position and depth of sacral hiatus on the surface of the body and its relationship with sacral ganglia and dura mater, and the optimal angle of sacral hiatus for perforation are summarized Measurement results can help clinicians safer sacroiliac cyst diagnosis and treatment, but also for caudal anesthesia, presacral radiofrequency nerve resection, and ultrasound provide a useful reference.