腰椎间孔侵入性操作的应用解剖

发布时间：2018-01-01 07:04

本文关键词：腰椎间孔侵入性操作的应用解剖　出处：《中国临床解剖学杂志》2010年02期 　论文类型：期刊论文

【摘要】：目的为腰椎间孔的侵入性操作提供解剖学依据。方法在10具防腐尸体上,解剖观测走行于L1～5椎间孔的血管、韧带和神经及其毗邻关系。结果腰椎间孔出口区几乎被神经血管封闭,在相邻两横突根(或横突根与骶翼)连线的中点紧贴椎板外缘,以及横突根(或骶翼)上缘存在2个相对无神经血管区(三角工作区),但有12%腰横突根上缘三角工作区出现腰升静脉或(和)椎间静脉下支至腰静脉的交通支。结论⑴"三角工作区"为相对无血管区;⑵腰椎侧后方手术要注意入路区可能存在血管;⑶腰椎间孔穿刺时,针尖宜从两横突根中点,并紧贴椎板外缘刺入;⑷由于椎间孔出口区几乎被神经血管封闭,针刀在此处盲切危险性较大。
[Abstract]:Objective to provide anatomical basis for invasive operation of intervertebral foramen of lumbar vertebrae. Methods Anatomical observation was performed on 10 embalmed cadavers. Results the outlet area of the intervertebral foramen was almost closed by nerve and blood vessels, and it was close to the outer edge of the lamina at the midpoint of the adjacent two transverse process roots (or between the transverse process root and the sacral wing). In addition, there were two relatively non-neurovascular areas (triangular workspace) in the upper margin of the transverse process root (or sacropterium). But there were 12% cases of ascending lumbar vein or / and communicating branch from inferior branch of intervertebral vein to lumbar vein in the triangular working area of upper margin of lumbar transverse process root. Conclusion 1 "triangular working area" is a relatively non-vascular area; 2Lateral posterior lumbar surgery should pay attention to the possible presence of blood vessels in the approach area; (3) in the puncture of intervertebral foramen, the needle tip should be punctured from the middle point of the two transverse process roots and sticking closely to the outer edge of the lamina. 4 because the outlet area of intervertebral foramen is almost blocked by nerve and blood vessel, the risk of blind cutting of needle knife here is greater.
【作者单位】：南方医科大学中医药学院骨伤推拿教研室;
【分类号】：R322
【正文快照】： 腰椎间孔及其外侧区是腰椎侧后方手术、椎间孔穿刺和针刀等治疗的操作部位[1～3]。但椎间孔及其外侧区的解剖结构复杂,在此操作易损伤神经和血管,而致严重的后遗症和医源性损伤[4]。故对椎间孔及其外侧区的解剖研究尤为重要,以往对腰椎间孔及其外侧区的韧带和血管各家报道不

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