腰部椎间孔间距与深度的CT测量及应用

Measurements of the distance between both intervertebral foramina of each lumbar vertebra and the depth from epidural space to lumbodorsal skin

椎间孔径路硬膜外注药有利于腰椎间盘突出症患者施行髓核化学溶解术。为建立该径路硬膜外穿刺的体表最佳穿刺点和穿利深度的测定方法,采用了CT技术,对100例健康成人(男、女各50例,平卧位)腰椎部进行横断扫描,由CT断层扫描图的游标尺测得双侧腰大肌之间及双侧椎弓根与腰背皮肤之间的距离,得出各腰椎间孔的间距与深度;另取12具新鲜尸体,取俯卧位,根据以上所得数据,确定最佳穿刺点及穿刺深度,成功地指导了各腰椎间孔径路硬膜外穿刺。在此基础之上,将该方法应用于临床,即:采用CT测出腰椎间盘突出症患者的有关椎间孔的间距与深度的数据指标,确定最佳穿刺点及穿刺深度,用于指导该穿刺的操作,60例的临床应用结果表明:一次穿刺成功为56例,成功率达90.3%。由此认为:椎间孔的间距与深度的CT测定对指导腰椎间孔径路硬膜外穿刺有很大意艾。

In order to find a method to determine the location and depth of epidural puncture through intervertebral foramen, the distance between both intervertebral foramina and the depth from epidural space to lumbodorsal skin were measured with computerized tomography(CT). These data were taken as a guide during lumbar epidural puncture through intervertebral foramen in 12 fresh corpses ,and needles were all successfully inserted into epidural spaces. Afterwards, this method was applied to the lumbar epidural puncture of 60 adult patients with lumbar vertebral disk herniation, in the sense that the distance between both intervertebral foramina and epidural depth were measured with CT as the guide in the epidural puncture through intervertebral foramen; only at sigle puncture, the epidural spaces of 56 cases were successfully inserted into ,with the rate of success being 90.3%. It is suggested that the dis- tance between both intervertebral foramina and epidural depth measured by CT, paly an important role in successful lumbar epidural puncture through intervertebral foramen.