胸腔镜下脊柱侧凸前方松解和矫形术中的解剖定位及其意义

Thoracoscopic anterior release and restoration for scoliosis:Anatomic localization and its clinical significance

目的 观察胸腔内解剖结构在胸腔镜下的标记 ,以助于术中的定位及预防并发症。 方法 对 2 3例胸腔镜下的脊柱前路手术进行了解剖标志的观察 ,主要指标为节段血管、奇静脉、椎间盘、肋骨头及内脏大神经。 结果 T6～ 10 节段血管位于椎体中央 ,较为恒定。T7～ 10 椎间盘隆起 ,呈白色 ,易于辨别。各椎体对应的肋骨头清晰可辨。内脏大神经于T7～ 9处斜行跨越椎体。 结论 借助于解剖标志可对椎体定位 ,以避免操作进入椎管损害脊髓 。

Objective To observe the anatomic landmarks in the thoracic cavity under thoracoscope in procedures for scoliosis,so as to facilitate the intraoperative localization and the prevention of complications. Methods During 23 cases of thoracoscopic anterior procedure,anatomic landmarks,including the segmental vessels,azygous vein,intervertebral discs,rib heads and great splanchnic nerve,were observed. Results The segmental vessels of T 6～10 were situated at the center of the vertebral body and their position was relatively constant.The T 7～10 intervertebral discs were a little bit prominent and white-colored,which were easily distinguished.The rib heads corresponding to their vertebral bodies were good landmarks.The great splanchnic nerve crossed over the T 7～9 vertebral bodies arrisways. Conclusions With the assistance of anatomic landmarks,accurate localization of the vertebral body is possible,which is helpful to the prevention of spinal cord injury and the decrease of frequency of radiation exposure.