METHODS: 18 anatomical dissections of lower limbs from 9 anatomical cadavers were performed. Endopelvic and exopelvic surgical approaches were utilized to study the anatomical variations of the nerve and to identify areas of entrapment.
RESULTS: On 7 limbs, the posterior branch of the obturator nerve passed through the external obturator muscle. A fascia between the adductor brevis and longus muscles was present in 9 of the 18 limbs. The anterior branch of the obturator nerve was highly adherent to the fascia in 6 cases. In 3 limbs, the medial femoral circumflex artery was in close connection with the posterior branch of the nerve.
CONCLUSIONS: Idiopathic obturator neuropathy remains a difficult diagnosis. Our cadaveric study did not allow us to formally identify one or more potential anatomical entrapment zones. However, it allowed the identification of zones at risk. A clinical study with staged analgesic blocks would be necessary to identify an anatomical area of compression and would allow targeted surgical neurolysis.
方法:对9具解剖尸体进行18次下肢解剖解剖。利用肾盂内和肾盂外手术方法研究神经的解剖变化并确定截留区域。
结果:在7个肢体上,闭孔神经的后支穿过闭孔外肌。在18个肢体中的9个中存在短收肌和长肌之间的筋膜。闭孔神经前支与筋膜高度粘附6例。在三个肢体中,旋股内侧动脉与神经后支紧密相连。
结论:特发性闭孔神经病仍然是一个困难的诊断。我们的尸体研究不允许我们正式确定一个或多个潜在的解剖截留区。然而,它允许识别处于危险中的区域。有必要进行分阶段镇痛块的临床研究,以确定压迫的解剖区域,并允许有针对性的手术神经溶解。