以第4腰血管腹侧支为蒂设计的转位移植髂骨瓣

The Design of the Position—Shifting Transplantation of Ilium Graft on the Basis of the Abdominal Branch of the Fouth Lumbar Arteries

本文观察15具(30侧)成人尸体第4腰血管腹侧支,主要结果如下:第4腰动脉腹侧支自 L_4椎间孔前缘椎弓根下方起始,经腰大肌及第3腰神经前支的后方从腰大肌外侧缘与腰方肌之间穿出,(穿出点在两侧髂嵴最高点连线与腰大肌外侧缘交点处或其上,下方6～15mm 之间)。沿腰方肌浅面行向前外方进入腹外侧肌,沿途有发至髂嵴中部恒定的营养支,以此为依据设计了带血管蒂的转位移植髂骨瓣,作为椎体融合,横突融合及腰椎结核病灶修复等的移植骨瓣。平均蒂长:自起始部至入骨点为61.5±9.20mm,自腰大肌外侧缘至入骨点为40.8±6.15mm。平均外径:起始处为2.1±0.14mm;腰大肌外缘为1.6±0.18mm。血供范围50×20mm。

In this article,We have studied the abdominal branch of the 4th lumbar arteries in 15(30 sides)adult ca- davers.The main results are as follows: The abdominal branch of the 4th lumbar arteries begins at the anterior edge of the 4th intervertebral foramen and the lower part of the pedicle of vertebral arch,through between the outside of the greater pasoas muscle and the back part of the anterior branch of the 3rd lumbar nerve and the lumbar quadrate muscle(the point is on the linding line of the highest point of the both sides of the iliac crest and the intersection of the lateral of the greater psoas muscle,or above,about 6—15 mm),along the shallow surface of the lumbar quadrate muscle ahead into the lateral muscle of the abdomen,there are stable nutrient branch on the way to the middle of iliac crest.The position—shifting transplantation of ilium graft with blood vessel base has been edsigned,according to the above stated,as a vertebral body fusion,transverse process fusion and the graft- ing ilium for reparing the focus of the lumbar tuberculosis.The average length of the base:from the begin- ning to point entering the bone 61.5±9.20mm,from the outside of the greater psoas muscle to the point en- tering the bone 40. 8±6.15mm.The average outer diameter:the beginning part 2.1±0.14mm;the outside of the greater psoas muscle 16±0.18mm;the blood supplying extent 50×20mm.