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1. 重庆三峡中心医院骨科中心,重庆,404100
2. 解放军66481部队,天津,301700
纸质出版日期:2019,
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李楠, 王浩明, 郭从涛, 等. L2~S1斜向腰椎椎间融合术椎间操作区的影像解剖学研究[J]. 局解手术学杂志, 2019,(4):303.
LI Nan, WANG Hao-ming, GUO Cong-tao, et al. Imaging anatomocal research on surgical area of intervertebral space in L2 to S1 oblique lumbar interbody fusion[J]. null, 2019,(4):303.
目的 观测L2~S1斜向腰椎椎间融合术(OLIF)椎间操作区的应用解剖学参数。 方法 收集87例成年人腹部CTA影像资料。观测L2~L3、L3~L4、L4~L5和L5~S1 OLIF椎间操作区解剖参数:血管区、裸露区、腰大肌肌区、实际手术区、理想手术区及椎间隙正中冠状面上左侧腰大肌的宽度。 结果 男性的L2~L3、L3~L4、L4~L5裸露区均大于女性,但女性的L5~S1裸露区大于男性。L3~L4腰大肌肌区最大,L4~L5肌区最小。L5~S1椎间隙没有腰大肌遮挡、没有肌区。L3~L4实际手术区最大,其次为L2~L3、L4~L5、L5~S1最小,各椎间隙实际手术区百分比分别为68%、65%、56%和42%。L4~L5椎间隙正中冠状面上左侧腰大肌的宽度最大,其次为L3~L4、L2~L3。椎间隙实际手术区小于1 cm者L4~L5有6例(6.9%)、L5~S1有23例(26.4%)。 结论 L2~S1 OLIF各椎间手术操作区的局部解剖有其特殊性,并不是所有椎间隙都适合OLIF手术。
Objective To observe the anatomical parameters of the surgical area of intervertebral space in L2 to S1 oblique lumbar interbody fusion (OLIF). Methods Selected abdominal computed tomography angiography data from 87 adults.The anatomical parameters of the surgical area at L2 to L3
L3 to L4
L4 to L5 and L5 to S1 levels were observed. Namely the vascular area
nude area
psoas major area
actual surgical area
ideal operative area and width of the left psoas major on the middle frontal plane
respectively. Results The nude areas of male at L2 to L3
L3 to L4
L4 to L5 were larger than the female
but the nude area of female at L5 to S1 was larger than the male.The psoas major area was the largest at L3 to L4
and it was the smallest at L4 to L5.The psoas major area was not existed at L5 to S1.The actual surgical area was largest at L3 to L4
followed by L2 to L3
L4 to L5 and L5 to S1
and the percentages of the actual surgical area were 68%
65%
56% and 42%
respectively.The width of the left psoas major on the middle frontal plane was largest at L4 to L5
followed by L3 to L4 and L2 to L3.There were 6 cases whose actual surgical area was less than 1 cm at L4 to L5 (6.9%)
and it was 23 cases at L5 to S1 (26.4%). Conclusion The surgical areas of intervertebral space in L2 to S1 have their own peculiarities
it was not suitable for all levels to have OLIF.
斜向腰椎椎间融合术CTA影像解剖脊柱微创椎间隙
oblique lumbar interbody fusioncomputed tomography angiographyimaging anatomyminimally invasive spine surgeryintervertebral space
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