摘要
目的:本研究旨在通过模拟经皮椎间孔镜技术,在俯卧位L_(4)、L_(5)椎体水平观察腰椎肉眼大体结构,测量相关解剖指标,为腰椎间孔镜手术选择适宜尺寸的工作套管提供解剖学依据,从而提高微创脊柱内镜手术的安全性和便捷性。方法:在成人尸体标本上,逐步解剖L_(4)、L_(5)节段,暴露椎间孔、椎体、椎弓根、关节突、椎间盘等结构,观察并测量相关结构,每具标本双侧解剖,分为左右两组进行观察和测量。结果:椎间孔的横径左侧(9.431±1.44)mm,右侧(8.811±1.76)mm;L_(5)上关节突前缘中点至L_(4)出口神经根的垂直距离左侧(3.294±0.83)mm,右侧3.474mm±0.75;L_(5)上关节突前缘中点到L_(4)/L_(5)椎间盘纤维环的最短距离左侧(9.814±1.23)mm,右侧(10.143±1.42)mm;冠状面上L_(4)出口神经根与正中线之间的夹角左侧(39.42±7.38)°,右侧(39.27±6.54)°;椎管内安全三角的底边左侧(16.239±2.76)mm,右侧(15.399±2.46)mm;高左侧(17.341±4.20)mm,右侧(17.052±4.27)mm;面积为(144.129±55.80)mm^(2),右侧(135.105±54.93)mm^(2);L_(5)神经根出硬膜囊处与上位椎间盘下缘的距离左侧(3.981±2.86)mm,右侧(3.802±2.79)mm。椎间孔左右两侧对比均差异无统计学意义(P>0.05)。结论:通过试验证实L_(4)/5节段存在一个允许经皮椎间孔镜技术在后外侧入路操作的安全工作区域,为临床研究提供了椎间孔的解剖学基础。
Objective:This study aims to observe the gross structure of the lumbar spine at the level of L_(4) and L_(5) vertebral bodies in the supine position through simulated percutaneous foraminoscopy technology,and measure relevant anatomical indicators,so as to provide anatomical basis for the selection of appropriate size of working cannula for lumbar foraminoscopy surgery,and to improve the safety and convenience of minimally invasive spinal endoscopic surgery.Methods:In adult cadaver specimens,L_(4) and L_(5) segments were dissected step by step,intervertebral foramina,vertebral body,pedicle,facet,intervertebral disc and other structures were exposed,and related structures were observed and measured.Each specimen was dissected on both sides,and divided into left and right groups for observation and measurement.Results:The transverse diameter of the foramina was(9.431±1.44)mm on the left and(8.811±1.76)mm on the right.The vertical distance from the midpoint of the leading edge of the superior articular process of L_(5) to the nerve root of L_(4) outlet was(3.294±0.83)mm on the left and(3.474±0.75)mm on the right.The shortest distance from the front midpoint of the superior articular process of L_(5) to the annulus fibrosus of L_(4)/L_(5) was(9.814±1.23)mm on the left and(10.143±1.42)mm on the right.The Angle between L_(4) outlet nerve root and median line on the coronal plane was(39.42±7.38)°on the left and(39.27±6.54)°on the right.The left side of the bottom edge of the intraspinal safety triangle was(16.239±2.76)mm,and the right side was(15.399±2.46)mm.Height of the left side was(17.341±4.20)mm,and that of the right side was(17.052±4.27)mm;The area was(144.129±55.80)mm^(2),the right side was(135.105±54.93)mm^(2);The distance between the dural sac of L_(5) nerve root and the lower edge of the upper disc was(3.981±2.86)mm on the left and(3.802±2.79)mm on the right.There was no statistical difference between the left and right sides of the foramen(P>0.05).Conclusion:The experiment confirmed that the
作者
陈浩
翟明玉
常晓盼
舒高
刘永
CHEN Hao;ZHAI Mingyu;CHANG Xiaopan;SHU Gao;LIU Yong
出处
《中医临床研究》
2022年第12期132-135,141,共5页
Clinical Journal Of Chinese Medicine
基金
深圳市坪山区卫生科研项目(201858)、广东省中医药局科研课题(20173014)。
关键词
腰椎退变
椎间孔镜技术
应用解剖
Lumbar degeneration
Intervertebral foramen lens technology
Applied anatomy
