目的探讨应用3D打印腰神经根变异(LNRA)模型测量Kambin三角面积变化的临床价值。方法选择2018年7月至2020年6月贵港市人民医院收治的LNRA患者4例,年龄44~65岁,男性2例,女性2例。变异类型:根联合型3例,尾侧起源型1例。通过采集患者的腰...目的探讨应用3D打印腰神经根变异(LNRA)模型测量Kambin三角面积变化的临床价值。方法选择2018年7月至2020年6月贵港市人民医院收治的LNRA患者4例,年龄44~65岁,男性2例,女性2例。变异类型:根联合型3例,尾侧起源型1例。通过采集患者的腰部三维MRI数据进行数字化医学建模,并测量Kambin三角区相关参数。通过3D打印技术构建患者LNRA模型,并在模型上实施孔镜置管模拟操作。结果基于3D打印模型的模拟操作发现,4例患者椎间孔Kambin三角面积分别为0.00 mm 2、11.60 mm 2、15.33 mm 2、22.20 mm 2,可容纳最大套管直径分别为0.00 mm、2.74 mm、3.88 mm、3.93 mm;椎管内Kambin三角面积分别为0.00 mm 2、26.72 mm 2、36.38 mm 2、76.88 mm 2,可容纳最大套管直径分别为0.00 mm、3.29 mm、5.33 mm、7.18 mm。结论3D打印LNRA模型可让临床医师对LNRA患者的Kambin三角区变化情况有直观、立体的了解,有利于降低手术风险,提高疗效。展开更多
Objective:We through the anatomy of cadavers to study the"Kambin’s triangle"in the safe working area of lumbar intervertebral foramen and to provide anatomical reference for clinical lumbar fusion through K...Objective:We through the anatomy of cadavers to study the"Kambin’s triangle"in the safe working area of lumbar intervertebral foramen and to provide anatomical reference for clinical lumbar fusion through Kambin’s triangle approach.Methods:five complete cadaveric specimens were taken,the soft tissue of the lumbar back was removed,the transverse process,upper and lower articular processes and part of the vertebral lamina were bitten,the Kambin’s triangle area of the lumbar spine was completely exposed,the bottom edge and height of the Kambin’s triangle were measured,and the area of the Kambin’s triangle was calculated;Using Kirschner wire,pull and fix the traveling nerve root to make the Kambin’s triangle into a rectangle,measure the length of the bottom edge and height again,calculate the area,and compare the two groups of data.Results:the average height of the Kambin’s triangle was 11.20mm±2.10mm,and the average height of the improved four corners was 11.19mm±1.93mm.The height of the improved four corners was slightly shorter than that of the Kambin’s triangle.There was a significant correlation between the two,but the difference was not statistically significant.The average bottom of Kambin’s triangle is 10.78mm±1.95mm,and the average bottom of improved four corners is 12.14mm±1.78mm.The length of the bottom edge of improved four corners is greater than that of Kambin’s triangle.There is a significant correlation between them,and the difference is statistically significant;The average area of Kambin’s triangle is 61.79mm^(2)±20.71mm^(2),and the area of improved four corners is 137.71mm^(2)±38.20mm^(2).The area of improved four corners is significantly larger than that of Kambin’s triangle.There is a significant correlation between the two,and the difference is statistically significant.Conclusion:there is a narrow right angle triangle area surrounded by traveling nerve root,dural sac and superior endplate of lower vertebral body in the lumbar intervertebral foramen.If the traveling nerve root is pulled and fixed to turn the traditional Kambin’s triangle into a quadrilateral,the bottom edge of the Kambin’s triangle area can be significantly longer and the area can be significantly expanded,which can be operated more safely.展开更多
文摘目的探讨应用3D打印腰神经根变异(LNRA)模型测量Kambin三角面积变化的临床价值。方法选择2018年7月至2020年6月贵港市人民医院收治的LNRA患者4例,年龄44~65岁,男性2例,女性2例。变异类型:根联合型3例,尾侧起源型1例。通过采集患者的腰部三维MRI数据进行数字化医学建模,并测量Kambin三角区相关参数。通过3D打印技术构建患者LNRA模型,并在模型上实施孔镜置管模拟操作。结果基于3D打印模型的模拟操作发现,4例患者椎间孔Kambin三角面积分别为0.00 mm 2、11.60 mm 2、15.33 mm 2、22.20 mm 2,可容纳最大套管直径分别为0.00 mm、2.74 mm、3.88 mm、3.93 mm;椎管内Kambin三角面积分别为0.00 mm 2、26.72 mm 2、36.38 mm 2、76.88 mm 2,可容纳最大套管直径分别为0.00 mm、3.29 mm、5.33 mm、7.18 mm。结论3D打印LNRA模型可让临床医师对LNRA患者的Kambin三角区变化情况有直观、立体的了解,有利于降低手术风险,提高疗效。
基金Hainan Provincial Natural Science Foundation(No.819QN365)National Natural Science Foundation of China(No.81902270)。
文摘Objective:We through the anatomy of cadavers to study the"Kambin’s triangle"in the safe working area of lumbar intervertebral foramen and to provide anatomical reference for clinical lumbar fusion through Kambin’s triangle approach.Methods:five complete cadaveric specimens were taken,the soft tissue of the lumbar back was removed,the transverse process,upper and lower articular processes and part of the vertebral lamina were bitten,the Kambin’s triangle area of the lumbar spine was completely exposed,the bottom edge and height of the Kambin’s triangle were measured,and the area of the Kambin’s triangle was calculated;Using Kirschner wire,pull and fix the traveling nerve root to make the Kambin’s triangle into a rectangle,measure the length of the bottom edge and height again,calculate the area,and compare the two groups of data.Results:the average height of the Kambin’s triangle was 11.20mm±2.10mm,and the average height of the improved four corners was 11.19mm±1.93mm.The height of the improved four corners was slightly shorter than that of the Kambin’s triangle.There was a significant correlation between the two,but the difference was not statistically significant.The average bottom of Kambin’s triangle is 10.78mm±1.95mm,and the average bottom of improved four corners is 12.14mm±1.78mm.The length of the bottom edge of improved four corners is greater than that of Kambin’s triangle.There is a significant correlation between them,and the difference is statistically significant;The average area of Kambin’s triangle is 61.79mm^(2)±20.71mm^(2),and the area of improved four corners is 137.71mm^(2)±38.20mm^(2).The area of improved four corners is significantly larger than that of Kambin’s triangle.There is a significant correlation between the two,and the difference is statistically significant.Conclusion:there is a narrow right angle triangle area surrounded by traveling nerve root,dural sac and superior endplate of lower vertebral body in the lumbar intervertebral foramen.If the traveling nerve root is pulled and fixed to turn the traditional Kambin’s triangle into a quadrilateral,the bottom edge of the Kambin’s triangle area can be significantly longer and the area can be significantly expanded,which can be operated more safely.
