腰椎间孔侵入性操作的应用解剖
Applied anatomy of intrusive operations of lumbar intervertebral foramen
袁仕国 1李义凯 1王华军 1潘长卿1
作者信息
- 1. 南方医科大学中医药学院骨伤推拿教研室,广州,510515
- 折叠
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L_(1-5)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,在相邻丽横突根(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 (1)"三角工作区"为相对无血管区;(2)腰椎侧后方手术要注意入路区可能存在血管;(3)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;(4)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 data for intrusive operations of lumbar intervertebral foramen. Methods Blood vessels, ligaments and nerves through L_(1-5) intervertebral foramen and their adjacent structures on 10 antisepsis corpses were dissected and observed. Results Lumbar intervertebral foramen exit zones were almost sealed with nerves and blood vessels. Two zones relatively lacking blood vessel and nerve (triangular working zones) were sat beside lamina of vertebral arch and the midpoint of the line of two adjacent roots of transverse processus, and upon root of transverse processus. Ascending lumbar vein and linking vein between intervertebral vein and lumbar veins were observed in 12% triangular working zones upon root of transverse processus. Conclusions Triangular working zone is relatively avascular zone. Attentions should be paid to the veins in admission passage zone for intrusive operations of posterolateral lumbar vertebra. Intervertebral foramen puncture is recommended to prick beside lamina of vertebral arch and the midpoint of the line of two adjacent roots of transverse processus. As lumbar intervertebral foramina exit zone is almost sealed with nerves and blood vessels, blind acupotomy is dangerous in this area.
关键词
椎间孔/椎间孔注射/三角工作区/腰椎间盘突出Key words
Intervertebral foramen/Injection through intervertebral foremen/Triangular working zone/Lumbar disc herniation引用本文复制引用
出版年
2010
NETL
NSTL
维普
万方数据