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any connection or unifying bond
a sheet or band of tough fibrous tissue connecting bones or cartilages or supporting muscles or organs

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靱帯(じんたい)(骨と骨を結びつてけ関節の動きを調節する)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/12/17 00:10:43」(JST)

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The sacrospinous ligament (small or anterior sacrosciatic ligament) is a thin, triangular ligament in the human pelvis. The base of the ligament is attached to the outer edge of the sacrum and coccyx, and the tip of the ligament attaches to the spine of the ischium, a bone in the human pelvis. Its fibres are intermingled with the sacrotuberous ligament.

Structure

The sacrotuberous ligament passes behind the sacrospinous ligament. In its entire length it covers the equally triangular coccygeus muscle, to which its closely connected.^[1]

Function

The presence of the ligament in the greater sciatic notch creates an opening (foramen]), the greater sciatic foramen, and also converts the lesser sciatic notch into the lesser sciatic foramen.^[2] The greater sciatic foramen lies above the ligament, and the lesser sciatic foramen lies below it.

The pudendal vessels and nerve pass behind the sacrospinous ligament directly medially and inferiorly to the ischial spine. The inferior gluteal artery, from a branch of the internal iliac artery, pass behind the sciatic nerve and the sacrospinous ligament and is left uncovered in a small opening above the top of the sacrospinous ligament. The coccygeal branch of the inferior gluteal artery passes behind the mid-portion of the sacrospinous ligament and pierces the sacrotuberous ligament at multiple locations. The main body of the inferior gluteal artery leaves the pelvis posteriorly to the upper border of the sacrospinous ligament, to follow the inferior portion of the sciatic nerve out of the greater sciatic foramen.^[3]

The main function of the ligament is to prevent rotation of the ilium past the sacrum. Laxity of this ligament and the sacrotuberous ligament allows this rotation to occur. Stresses to these ligaments occur most often when leaning forward or getting out of a chair.^{[citation needed]}

Clinical significance

Vaginal prolapse or uterine prolapse may occur in women when other pelvic ligaments and supportive structures are weakened. One treatment is sacrospinous fixation. In this surgery, the apex of the vagina has a sling implanted in surgery. This travels under the vagina and is attached to the sacrospinous ligament, which may offer a sturdier support than weakened pelvic ligaments, ideally preventing further prolapse.^[4]

Additional images

Nélaton’s line and Bryant’s triangle.
Articulations of pelvis. Posterior view.

Notes

^ Gray's Anatomy 1918
^ Platzer (2004), p 188
^ Thompson et al. (1999)
^ Vasavada et al. (2004), p 661

References

This article incorporates text in the public domain from the 20th edition of Gray's Anatomy (1918)

Thompson, Jason R.; Gibb, John S.; Genadry, Rene; Burrows, Lara; Lambrou, Nicholas; Buller, Jerome L. (1999). "Anatomy of Pelvic Arteries Adjacent to the Sacrospinous Ligament: Importance of the Coccygeal Branch of the Inferior Gluteal Artery". Obstetrics & Gynecology (Baltimore, Maryland.: Johns Hopkins University) 94 (6): 973–977. doi:10.1016/s0029-7844(99)00418-4. PMID 10576185.
Platzer, Werner (2004). Color Atlas of Human Anatomy, Vol 1: Locomotor system (5th ed.). Thieme. ISBN 3-13-533305-1. (ISBN for the Americas 1-58890-159-9.)
Vasavada, Sandip P.; Appell, Rodney; Sand, Peter K.; Raz, Shlomo (2004). Female Urology, Urogynecology, and Voiding Dysfunction. Informa Health Care. ISBN 0-8247-5426-3.

External links

Anatomy figure: 17:02-03 at Human Anatomy Online, SUNY Downstate Medical Center - "Posterior view of the bones and ligaments of the hip joint."
Johns Hopkins

UpToDate Contents

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1. 女性の骨盤臓器脱：先端脱（子宮脱または膣円蓋脱）の外科的修復 pelvic organ prolapse in women surgical repair of apical prolapse uterine or vaginal vault prolapse
2. 女性の骨盤臓器脱：一次手術の術式選択 pelvic organ prolapse in women choosing a primary surgical procedure
3. 子宮摘出時の予防的膣尖部挙上術 prophylactic vaginal apex suspension at the time of hysterectomy
4. 骨盤手術に関連する神経損傷 nerve injury associated with pelvic surgery
5. 女性泌尿生殖器の外科解剖学 surgical female urogenital anatomy

English Journal

Transvaginal management of severe pelvic organ prolapse in nulliparous women.

Lo TS1,2,3, Jaili S4,5, Uy-Patrimonio MC4,6, Karim NB4,7, Ibrahim R4,8.
The journal of obstetrics and gynaecology research.J Obstet Gynaecol Res.2017 Feb 4. doi: 10.1111/jog.13234. [Epub ahead of print]
AIM: The aim of this study was to evaluate the management outcomes of advanced pelvic organ prolapse (POP) in nulliparous women.METHODS: Eight nulliparous women diagnosed with POP ≥ stage 3 between January 2005 and August 2013, according to the Pelvic Organ Quantification System (POPQ), were rev
PMID 28160508

Native tissue repair for central compartment prolapse: a narrative review.

Paz-Levy D1, Yohay D1, Neymeyer J2, Hizkiyahu R1, Weintraub AY3.
International urogynecology journal.Int Urogynecol J.2017 Feb;28(2):181-189. doi: 10.1007/s00192-016-3032-6. Epub 2016 May 21.
Central descent due to a level 1 defect is a main component in pelvic organ prolapse (POP) reconstructive surgery, whether for symptomatic apical prolapse or for the prolapse repair of other compartments. A recent growth in the rate of native tissue repair procedures for POP, following the US Food a
PMID 27209309

Comparative Anatomy of the Ovine and Female Pelvis.

Urbankova I1, Vdoviakova K, Rynkevic R, Sindhwani N, Deprest D, Feola A, Herijgers P, Krofta L, Deprest J.
Gynecologic and obstetric investigation.Gynecol Obstet Invest.2017 Jan 27. doi: 10.1159/000454771. [Epub ahead of print]
BACKGROUND: Pelvic organ prolapse affects half of vaginally parous women. Several animal models are used to study its pathophysiology and treatment. Sheep are interesting because they develop spontaneously prolapse with similar risk factors as women and can be used for vaginal surgery. This study de
PMID 28125816

Japanese Journal

ISO-3-7 Outcomes of Sacrospinous Ligament Fixation for Treating Female Pelvic Organ Prolapse(Group 3 Reproduction/Women's Health,IS Award Candidate,International Session)

Ng Soo-Cheen,Chen Gin-Den
日本産科婦人科學會雜誌 65(2), 979, 2013-02-01
NAID 110009639676

性器脱手術--仙棘靱帯子宮頸部固定術 (手術手技尿失禁に関連した手術(4))

中田真木
臨床泌尿器科 62(9), 659-665, 2008-08
NAID 40016177553

手術性器脱に対する腟上端仙棘靱帯固定術施行132症例の検討 : 仙棘靱帯固定専用デシャンの作成と使用経験

島野敏司,工藤隆一
産婦人科治療 = Obstetrical and gynecological therapy 89(2), 253-260, 2004-08
NAID 40019872447

「仙棘靭帯」

Sacrospinous ligament
	Articulations of pelvis, anterior view, with greater sciatic foramen (labeled in red) and its boundaries.
Details
Latin	ligamentum sacrospinosum
From	Ischial spine
To	Sacrum
Identifiers
Gray's	p.309
TA	A03.6.03.005
FMA	21479
	Anatomical terminology

　　[★]

英: sacrospinous ligament (M,K)
ラ: ligamentum sacrospinale
関: 陰部神経管、仙骨、坐骨棘

仙骨の下部と坐骨棘の間に張る
仙結節靭帯とともに大坐骨孔を形成する

[1] Gray's Anatomy 1918

[Platzer-188-2] Platzer (2004), p 188

[Thompson-1999-3] Thompson et al. (1999)

[Vasavada-661-4] Vasavada et al. (2004), p 661

匿名

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案内

案内

sacrospinous ligament