壮族人群极外侧椎间融合术的影像解剖研究

The imaging anatomy study of Zhuang population using transpsoas extreme lateral interbody fusion

目的确定壮族人群极外侧椎间融合术的安全操作范围。方法测量壮族人群腰椎MRI腰大肌和椎体的前后径,腰丛、椎体、腰大肌、腹部大血管的相对距离,血管外侧缘相对椎体中线的角度。结果壮族人群XLIF的安全操作范围从L1-2至L3-4相邻节段无明显差异,在L4-5比L3-4小;左侧安全操作范围比右侧大,女性比男性小。结论 （1）壮族人群可从两侧行XLIF;（2）壮族人群XLIF的腰大肌穿刺点,L1-2、L4-5节段位于椎体的Ⅱ、Ⅲ区,L2-3、L3-4节段位于椎体的Ⅲ区。

Objective To define the safe working zone using the extreme lateral interbody fusion （XLIF）. Methods We retrospectively evaluated lumbar spine MRI. Relevant parameters were measured from axial magnetic resonance images and analyzed, including the vertebrae endplate and psoas muscle diameters, the overlap between the lumbar plexus, the endplate of the vertebral body, the psoas muscle, the retropefitoneal vessels, and the angle of the retroperitoneal vessels. Results The SWZ （safe working zone） of extreme lateral interbody fusion from L1-2 to L3-4 had no significant difference. The SWZ of L4-5 level was smaller than that at L3-4 level. The fight SWZ was significant smaller than the left SWZ; the SWZ of female was smaller than that of male. Conclusions （1）The left side and right side are suitable for the Zhuang population using XLIF. （2）The puncture point of the Zhuang population using XLIF lies in zone Ⅱ and zone Ⅲ at L1-L2,L4-L5 level （zone Ⅲ at L2-L3,L3-L4 level）.