经皮腰椎间盘后外侧入路“三角工作区”的薄层断面解剖和三维重建

reconstruction of posterolateral approach ＂triangular work- ing zone＂ in percutaneous lumbar discectomy

目的探明经皮腰椎间盘后外侧入路“三角工作区”的连续薄层断面的形态和三维结构。寻求解决“工作三角”的确切定义。方法选取2例中国数字化可视人体数据，对经皮腰椎间盘后外侧入路的连续断面形态进行解剖学观测并进行三维重建。结果获得经皮腰椎间盘后外侧入路的连续薄层断面形态学特征、相关测量参数和三维结构。“三角工作区”的面积为（23．70±8．73）mm^2，腰椎间盘穿刺虽是比较安全的区域，但有腰动脉脊支、椎间静脉和椎内静脉通过。结论经皮腰椎间盘后外侧入路“工作三角”的连续薄层断面数据集和三维重建可良好显示其形态和三维结构。初步明确了“工作三角”的定义，进一步证实腰动脉脊支、椎间静脉和椎内静脉是穿刺出血的解剖学基础。

Objective To clarify the sectional anatomy and three-dimensional structure of the posterolateral approach ＂triangular working zone＂ for pereutaneous lumbar discectomy. Methods Two sets of Chinese visible human data were selected for the continuous observation of the sectional morphology and three dimensional reconstruction of the posterolateral approach zone in pereutaneous lumbar discectomy. Results The characteristics of consecutive sectional morphology, relevant measurement parameters and three-dimensional structure of the posterolateral approach zone in pereutaneous lumbar discectomy were obtained. The ＂triangular working zone＂ has an area of 23. 70 ± 8.73 mm^2, with a branch of lumbar artery, an intervertebral vein and an internal vertebral vein passing through the region, though it is a relatively safe region for lumbar disc puncture. Conclusion The consecutive sectional data sets of the posterolateral approach ＂work triangle＂ in pereutaneous lumbar discectomy can render a precise three-dimensional reconstruction of this region. We also further confirm that the spinal branch of lumbar artery, intervertebral vein and internal vertebral vein are the anatomical factors for puncture bleeding.