Chinese Journal of Tissue Engineering Research ›› 2019, Vol. 23 ›› Issue (4): 573-577.doi: 10.3969/j.issn.2095-4344.1039

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Anatomic measurement and clinical significance of the lumbosacral nerve roots

Zhu Aiguo1, Zhang Feng2, Zhu Jianwei2, Jin Guohua3   

  1. 1Department of Orthopedics, Rudong People’s Hospital，Rudong 226400, Jiangsu Province, China; 2Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China; 3Department of Anatomy, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
  • Online:2019-02-08 Published:2019-02-08
  • Contact: Zhang Feng, MD, Chief physician, Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
  • About author:Zhu Aiguo, Master, Associate chief physician, Department of Orthopedics, Rudong People’s Hospital, Rudong 226400, Jiangsu Province, China

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Abstract:

BACKGROUND: Reconstruction of low lumbar vertebrae using subtotal vertebrectomy through posterior approach can result in severe damage to lumbosacral plexus.

OBJECTIVE: To explore the distance between lumbosacral nerve roots and the relationship between the lumbosacral plexus and lumbar vertebrae in the coronary plane, providing anatomical basis for the reconstruction of low lumbar vertebrae by subtotal vertebrectomy through posterior approach.
METHODS: Posterior dissections of the lumbosacral plexus and corresponding vertebrae were performed bilaterally on 20 adult cadavers. We measured the distance from the inferior border of the superior nerve root to the superior border of the next-most inferior nerve root was measured, at the point where the nerve roots emerged from the common dural sac; the distance along each nerve root from its emergence from the common dural sac to its first connection with the plexus of the adjacent root, and these measurements were taken at L2-L5 bilaterally. The height and diameter of the posterior margin of L3-L5 vertebrae, and the angle between the nerve root and dural sac from L3 to L5 bilaterally were measured. 
RESULTS AND CONCLUSION: The mean area of the unilateral lumbosacral plexus at L3 was about 30 mm2 smaller than the corresponding hemivertebrate in the coronary plane. The mean area of the unilateral lumbosacral plexus at L4 was about 100-150 mm2 larger than the corresponding hemivertebrate in the coronary plane. The area of the lateral lumbosacral plexus at L5 was about 15 mm2 in males larger than the corresponding hemivertebrate in the coronary plane, and it was about 180 mm2 in females. In summary, reconstruction of low lumbar vertebrae by subtotal vertebrectomy at L3, L4 and L5 through posterior approach is feasible without the risk of damaging the surrounding nervous structures, especially at L4.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Lumbar Vertebrae, Lumbosarcal Plexus, Dissection, Tissue Engineering

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