经皮穿刺椎间盘切除术的应用解剖

Applied anatomy on percutaneous discectomy

对31具成尸 L4～5、L5～S1椎间盘及周围结构进行了观测,提出L4～5椎间盘经皮穿刺切除术以左侧进针为宜,进针处平髂嵴连线或其下方1～2cm,距后正中线6～8cm,进针方向与矢状面呈45°,深度8～10cm;L5～S1椎间盘进针处于髂后上棘处距后正中线5～6cm,进针方向与矢状面呈30°,与水平面呈向前下15°～20°的角,深度8～10cm。

The shape and syntopy of the intervertebral discs at the L4～L5 and L5～S1 levels were ob-served in 31 adult cadaveric specimens.Based on the results,it is believed that for percutaneousdiscectomy at L4～L5 level,lateral approach from the left side is appropriate.The puncture pointis located at the iliac crest level or l～2cm below it and 6～8cm lateral to the posterior medionline penetrating for 8～10cm in depth by the direction of 45 degrees to the sagittal plane.For L5～S1 level percutaneous discectomy,the puncture point is 5～6cm lateral to the posterior medianline at the level of posterosuperior iliac spine,penetrating for 8～10cm in depth by the directionof 30 degrees to the sagittal plane and 15～20 degrees anteroinferiorly.