The morphology of lumbar sympathetic trunk in humans: a cadaveric study

• Autorzy: Gandhi K.R. , Verma V. K. , Chavan S. K. , Joshi S. D. , Joshi S. S.
• Języki publikacji: EN

Abstrakty

EN

The vasospastic diseases and chronic pain related to lower limb have been successfully treated by surgical ablation of lumbar sympathetic trunk for last 80 years. Precise knowledge of anatomy of lumbar sympathetic trunk and its adjoining structures is mandatory for safe and uncomplicated lumbar and spinal surgeries. We aim to study the detailed anatomy of entry and exit of lumbar sympathetic trunk, the number, dimensions and location of lumbar ganglia in relation to lumbar vertebra. Thorough dissection was carried out in 30 formalin embalmed cadavers available in the Department of Anatomy, Pravara Institute of Medical Sciences (PIMS), Rural Medical College (RMC), Loni, Maharashtra. A total of 238 ganglia were observed in 60 lumbar sympathetic trunks. The sympathetic trunk traversed dorsal to the crus of diaphragm in 72.6% and in 13.3% it entered dorsal to the medial arcuate ligament. The most common site of the location of lumbar ganglia was in relation to the second lumbar vertebra, sometimes extending up to the L2–L3 vertebral disc. There was a medial shift of sympathetic trunk in lumbar region and it coursed over sacral promontory to reach the pelvic region in 96% of specimens. These variations should be kept in mind in order to prevent hazardous complications like accidental avulsion of first lumbar ganglia and genitofemoral neuritis. (Folia Morphol 2013; 72, 3: 217–222)

Słowa kluczowe

EN

morphology; lumbar sympathetic trunk; man; cadaver; human disease; vasospastic disease; vasospasm; chronic pain; limb; lower limb

• Wydawca: -
• Czasopismo: Folia Morphologica
• Rocznik: 2013
• Tom: 72
• Numer: 3
• Opis fizyczny: p.217-222,fig.,ref.

Twórcy

autor

Gandhi K.R.

• Pravara Institute of Medical Sciences, Loni, Maharashtra, India

autor

Verma V. K.

• Department of Orthopedics, People’s Medical College, Bhopal, India

autor

Chavan S. K.

• Pravara Institute of Medical Sciences, Loni, Maharashtra, India

autor

Joshi S. D.

• Pravara Institute of Medical Sciences, Loni, Maharashtra, India

autor

Joshi S. S.

• Pravara Institute of Medical Sciences, Loni, Maharashtra, India

Bibliografia

• 1. Beglaibter N, Berlatzky Y, Zamir O, Spira R, Freund H (2002) Retroperitoneoscopic lumbar sympathectomy. J Vascular Surgery, 35: 815–817.
• 2. Borley Neil, Standring Susan (2008) Gray’s anatomy. In: Autonomic supply. 40th Ed. Churchill Livingstone, London, pp. 1043–1046.
• 3. Cotton LT, Cross FW (1985) Lumbar sympathectomy for arterial disease. BJS, 72: 678–683.
• 4. Datta S, Umeshraya P (2004) Paradiscal extraforaminal technique for lumbar sympathetic block: report of a proposed new technique utilizing a cadaver study. Pain Physician, 7: 53–57.
• 5. Feigl GC, Kastner M, Ulz H, Breschan C, Dreu M, Likar R (2011) Topography of the lumbar sympathetic trunk in normal lumbar spines and spines with spondylophytes. BJA,106: 260–265.
• 6. Jit I, Mukerjee RN (1960) Observations on the anatomy of the human thoracic sympathetic chain and its branches; with an anatomical assessment of operations for Hypertension. JASI, 9: 55–82.
• 7. Kantha S, Kantha B (2007) Lumbar sympathectomy by laser technique. Inter J Minimally Invasive Surgical Tech, 1: 1–8.
• 8. Loureiro M de P, de Campos JRM, Kauffman P, Jatene FB, Weigmann S, Fontana A (2008) Endoscopic lumbar sympathectomy for women: effect on compensatory sweat. Clinics, 63: 189–196.
• 9. Lowenberg RI, Morton DE (1951) The anatomic and surgical significance of the lumbar sympathetic nervous system. Ann Surgery, 133: 525–532.
• 10. Murata Y, Takahashi K, Yamagata M, Takahashi Y, Shimada Y, Moriya H (2003) Variations in the number and position of human lumbar sympathetic ganglia and rami communicantes. Clin Anat, 16: 108–113.
• 11. Pick J (1957) The identification of sympathetic segments. Ann Surgery, 7: 355–364.
• 12. Quayle JB (1980) Sexual function after bilateral lumbar sympathectomy and aorto-iliac bypass surgery. J Cardiovascular Surgery, 21: 215–218.
• 13. Rocco AG, Palombi D, Raeke D (1995) Anatomy of the lumbar sympathetic chain. Regional Anesthesia, 20: 13–19.
• 14. Rutherford RB (1984) Vascular surgery. 2nd Ed. WB Saunders, Philadelphia.
• 15. Webber RH (1955) An analysis of the sympathetic trunk, communicating rami, sympathetic roots and visceral rami in the lumbar region in man. Ann Surgery, 141: 398–413.
• 16. Yeager GH, Cowley RA (1948) Anatomical observations on the lumbar sympathetics with evaluation of sympathectomies in organic peripheral vascular disease. Ann Surgery, 127: 953–967.