The dermatomes in man
The dermatomes in man
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DOI：
10.1093/brain/56.1.1
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发表时间：
1933-01-01
期刊：
影响因子：
14.5
通讯作者：
Foerster, O
中科院分区：
文献类型：
--
作者：
Foerster, O
[长划线] 30 年间。在神经外科的研究中，作者已经能够通过谢林顿的方法绘制出人体几乎所有的皮区（即，通过勾画出大量连续的根被分割后剩余的感觉的边界，并且中间的单个根保持完整）。结果表明，人类的皮节重叠程度与猴子的皮节重叠程度相同。人类在切除单个牙根后绝不会丧失敏感性，这一点可以通过通常的临床检查方法辨别出来。当单个后根被分割时，只能通过仔细数数。通过精确测量机械和电刺激点的阈值，可以减少该根部支配的区域的压力和疼痛点。可以证明根纤维与皮肤的连接。触觉皮节比疼痛皮节和热皮节大。连续根切除后镇痛和热麻醉的面积总是大于触觉麻醉的面积。有时，切除两个相邻的根仅产生镇痛和热麻醉，但不产生触觉麻醉。电刺激后根产生的血管舒张区域与隔离方法定义的皮区相似，但并不完全相同。前者与疱疹出疹的部位非常相似。单个皮节不仅代表相应根的整体，而且代表根的每根细丝。当除了几个根中的每一个之外的所有细丝被切断时，不会产生麻醉效果，每个相应的皮节都保留其敏感性。几位研究人员在动物身上证明了这一点，并且可以在人类身上观察到。在一些情况下，当腰椎和骶根的每个约 2/3 甚至更多被切除，只留下每个根的一小根完整的细丝时，敏感性得以保留。
[long dash]During 30 yrs. of neural surgery the author has been able to map out nearly all the dermatomes in man by Sherrington''s method (i.e., by outlining the borders of the sensibility which remains after a large no. of contiguous roots have been divided, and a single root in the middle has been left intact). The results show that the dermatomes of man overlap to the same large degree as do those of the monkey. Resection of a single root in man was never followed by loss of sensibility, discernible by the usual clinical methods of examination. When a single posterior root has been divided it is only by counting carefully the no. of pressure and pain spots in the area innervated by that root, and by measuring exactly the threshold of the spots for mechanical and electrical stimuli, that a diminution in the no. of root fibers connected with the skin can be demonstrated. The tactile dermatomes are larger than the pain and thermal dermatomes. The area of analgesia and thermanesthesia following resection of contiguous roots is always larger than the area of tactile anesthesia. Sometimes the resection of 2 contiguous roots produces analgesia and thermanesthesia, only, but no tactile anesthesia. The areas of vasodilatation produced by electrical stimulation of posterior roots are similar to the dermatomes defined by the isolation method, but not identical with them. The former are very similar to the areas of herpetic eruption. A single dermatome is represented not only in the totality of the corresponding root, but in every filament of the root. When all filaments except one of each of several roots are cut, no anesthesia results, each of the corresponding dermatomes preserves its sensibility. This was demonstrated in animals by several investigators, and can be observed in man. In several cases, when about 2/3 and even more of each of the lumbar and sacral roots was resected, leaving intact a small filament only of each root, sensibility was preserved.