壮族人群极外侧椎间融合术的影像解剖研究
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摘要
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 retroperitoneal vessels, and the angle of the retroperitoneal vessels. Results The SWZ(safe working zone)of extreme lateral interbody fusion from L1~2to L3~4had no significant difference. The SWZ of L4~5level was smaller than that at L3~4level. The right 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 Ⅱand zone Ⅲat L1~L2,L4~L5level(zone Ⅲ at L2~L3,L3~L4level).
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 retroperitoneal vessels, and the angle of the retroperitoneal vessels. Results The SWZ(safe working zone)of extreme lateral interbody fusion from L1~2to L3~4had no significant difference. The SWZ of L4~5level was smaller than that at L3~4level. The right 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 Ⅱand zone Ⅲat L1~L2,L4~L5level(zone Ⅲ at L2~L3,L3~L4level).
引文
[1]张烽,段广超,王素春,等.下腰椎侧方血管神经及毗邻结构的应用解剖[J].中国临床解剖学杂志,2007,25(02):152-155.
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[8]Beng Lis DM,Vanni S,Levi AD.An anatomical study of the lumbosacral plexus as related to the minimally invasive transpsoas approach to the lumbar spine[J].J Neurosurg Spine,2009,10(2):139-144.
[9]Cappuccino A,Cornwall GB,Turner AW,et al.Biomechanical analysis and review of Lateral lumbar fusion constructs[J].Spine(Phila Pa1976),2010,35(26S):S361-S367.
[10]Le TV,Baaj AA,Dakwar E,et al.Subsidence of polyetheretherketone intervertebral cages in minimally invasive lateral retroperitoneal extreme lateral interbody fusion[J].Spine(Phila Pa 1976),2012,37(14):1268-1273.
[2]Guerin P,Obeid I,Gille O,et al.Safe working zones using the minimally invasive Lateral retroperitoneal transpsoas approach:A morphometric study[J].Surg Radiol Anat,2011,33(8):665-671.
[3]Yusof MI,Nadarajan E,Abdullah MS.The morphometric study of L3-L4 and L4-L5 Lumbar spine in asian population using magnetic resonance imaging:Feasibility analysis for extreme lateral interbody fusion[J].Spine(Phila Pa 1976),2014,39(14):811-816.
[4]Kep Ler CK,Bogner EA,Herzog RJ,et al.Anatomy of the psoas muscle and lumbar plexus with respect to the surgical approach for lateral transpsoas interbody fusion[J].Eur Spine J,2011,20(4):550-556.
[5]Bergey DL,Villavicencio AT,Goldstein T,et al.Endoscopic lateral transpsoas approach to the lumbar spine[J].Spine(Phila Pa 1976),2004,29(15):1681-1688.
[6]Guerin P,Obeid I,Bourghli A,et al.The lumbosacral p Lexus:Anatomic considerations for minimally invasive retroperitoneal transpsoas approach[J].Surg Radiol Anat,2012,34(2):151-157.
[7]Moro T,Kikuchi S,Konno S,et al.An anatomic study of the lumbar plexus with respect to retroperitoneal endoscopic surgery[J].Spine(Phila Pa 1976),2003,28(5):423-428.
[8]Beng Lis DM,Vanni S,Levi AD.An anatomical study of the lumbosacral plexus as related to the minimally invasive transpsoas approach to the lumbar spine[J].J Neurosurg Spine,2009,10(2):139-144.
[9]Cappuccino A,Cornwall GB,Turner AW,et al.Biomechanical analysis and review of Lateral lumbar fusion constructs[J].Spine(Phila Pa1976),2010,35(26S):S361-S367.
[10]Le TV,Baaj AA,Dakwar E,et al.Subsidence of polyetheretherketone intervertebral cages in minimally invasive lateral retroperitoneal extreme lateral interbody fusion[J].Spine(Phila Pa 1976),2012,37(14):1268-1273.