下腰椎前方血管及毗邻结构的应用解剖

An applied anatomic study on the anterior vessels and their circum-structure of the low lumbar vertebrae

目的为微创下腰椎前路椎体间融合术(ALIF)提供解剖学依据。方法解剖30具成人尸体,观测下腰椎前方血管走行、分布及毗邻关系。结果髂总静脉汇合点相对恒定,主要分布在L4/5椎间隙及L5椎体上半(86.7%);而腹主动脉分叉点位置变异较大,相对分散。L5/S1椎间隙手术窗平均男36.07mm,女34.64mm。结论(1)微创ALIF在L5/S1间隙是可行的;(2)微创ALIF在L3/4、L4/5间隙进行必须充分游离牵开下腰椎前方血管及毗邻结构。

Objective To provide the anatomic data for lower lumbar spine inter-body fusion through the anterior approach mini-operation. Methads This study investigated 30 human cadavers to record the course, distribution and relation of the anterior vessels and their circum-structure to the low lumbar vertebrae. Results The conflyence level of the common liac vein was consistent. The width of the operation window of L5/S1 disc was in an average of 36.07 mm for males and 34. 64 mm for females. Conclusion The anterior mini-operation of the L5/S1 disc inter-body fusion is reliable and safe. However,the operation on the L3/4 disc and L4/5 disc is impossible without significant vascular dissection.