腰椎椎间管和椎间管外区应用解剖学研究

APPLICATIVE ANATOMY FOR LUMBAR FORAMINAL AND EXTRAFORMINAL REGION

目的 :探讨不同节段腰椎椎间管和椎间管外区骨性结构特点。方法 :作者对 3 2具中国成人腰骶椎骨标本进行了形态研究。结果 :L1 ～L5 椎弓根水平宽、椎板峡部宽、下关节突最外侧缘至正中矢状面距离和L1 至S1 上关节突最外侧缘至正中矢状面距离逐渐增大 ,尤以L4、L5 增大显著 ;L4、L5 横突基部下缘较其它 3个椎骨横突基部下缘显著下移 ,因而L4/L5 、L5 /S1关节突关节显著上移。结论 :从后面观 ,L1 /L2 至L5 /S1 手术窗逐渐减小并显著向外侧移 ,尤以L4/L5 、L5 /S1 显著。

Objective:To have a clear understanding of specific osseous features of lumbar foraminal and extraforaminal region. Methods:Morphometric studies of intact osseous specimens of the sacrolumbar vertebrae were made on 32 cadavers of Chinese origin with direct measurement.Results:From L 1 to L 5,measurements show that the width of pedicle of vertebral arch, the distances from the lateral margin of the pars interarticularis and the inferior articular process to the midst sagittal plane become progressively wider. From L 1 to S 1, measurements show that the distances from the superior articular process to the midst sagittal plane become progressively wider. It also show that the distances from the inferior border of the origin of the L 4 and L 5 transverse processes are lower than others and that L 4/L 5 and L 5/S 1 facet joints are higher than others.Conclusion:The operative window of L 1/L 2 to L 5/S 1 becomes progressively smaller and moves to lateral further and especially L 4/L 5 and L 5/S 1.