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腰骶丛综合征

Author
Paul T Twydell, DO
Section Editor
Jeremy M Shefner, MD, PhD
Deputy Editor
John F Dashe, MD, PhD
Translators
董继宏, 副主任医师

引言

腰骶丛病(lumbosacral plexopathy, LSP)是一组独特的周围神经系统疾病，部分原因是与其他周围神经疾病相比相对罕见，还有部分原因是其病因广泛。为了有效地治疗此类疾病，临床医生必须透彻地掌握腰骶丛的解剖学、LSP的最常见病因，以及当前最受认可的诊断方法。

其他累及下肢的神经病见其他专题。 (参见“下肢周围神经综合征概述”和“腰骶神经根病：病理生理学、临床特征及诊断”和“急性腰骶神经根病：预后与治疗”)

解剖

腰丛和骶丛共同构成腰骶丛，由L1-S4的神经根前支(腹侧支)形成(图 1)。前支在丛内分为前侧和后侧分支，继而产生各个周围神经。

腰丛由L1-L4的神经根前支组成。这些前支沿着腰大肌向下向外走行，最终在腰大肌处形成腰丛。在腰大肌以内时分为前侧和后侧的分支。L2-L4前支的后侧分支形成股神经，该神经从腰大肌外侧穿出，穿过髂肌并沿腹股沟韧带下走行，到达大腿前侧。前侧分支形成闭孔神经，该神经从腰大肌内侧穿出，沿骶骨翼走行，穿过闭孔到达大腿内侧。腰丛还发出大腿的股外侧皮神经、髂腹下神经、髂腹股沟神经和生殖股神经[1]。

腰丛和骶丛经腰骶干汇合，腰骶干由L4神经根前支的部分纤维和L5前支的所有纤维构成。腰骶干越过骶骨翼并加入S1-S4的神经根前支，形成完整的骶丛[1]。

                          

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Literature review current through: 2017-06 . | This topic last updated: 2016-12-21.
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