椎间盘镜后路下腰椎间盘切除术的应用解剖  

Applied anatomy of low lumbar vertebrae discectomy through diskoscopic posterior approach

作　　者：詹俊锋[1] 刘金伟[1] 周兵[1] 霍荻 董玉科[1] 丁自海[1] 

机构地区：[1]南方医科大学微创外科解剖学研究所,广州510515

出　　处：《中国临床解剖学杂志》2009年第2期159-161,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的:为下腰椎椎间盘镜手术入路提供解剖学依据。方法:20具L3～S1成人尸体标本,观测黄韧带、椎板、神经根、椎间盘之间的解剖关系。结果:①L3～L5下关节突外缘到棘突根部距离分别(11.44±1.67)、(14.67±1.76)和(19.90±1.70)mm;②L3～L5黄韧带椎板附着处到椎板下缘距离分别(14.14±2.40)、(11.80±2.41)和(4.85±2.07)mm;③L3～L5椎板下缘与相应椎间盘上缘垂直距离分别(11.56±2.07)、(9.25±2.82)和(0.51±3.12)mm;④L4～S1椎板上缘到相应神经根出硬膜的垂直距离分别(5.27±1.66)、(-6.76±4.36)和(-12.35±4.94)mm;⑤L4～S1神经根出硬膜到上位椎间盘下缘的垂直距离分别(8.14±2.72)、(0.86±4.98)和(-8.61±3.39)mm;⑥L3～L5神经根出硬膜到下位椎间盘上缘垂直距离分别(11.14±2.80)、(13.30±3.81)和(18.42±4.51)mm。结论:掌握下腰椎不同节段解剖特点,有利于椎间盘镜下手术工作通道的放置和操作的顺利进行。Objective： To provide anatomic basis for low lumbar vertebrae discectomy through diskoscope. Methods： Anatomic structures, including ligamentum flavum, vertebral plate, nerve root, and intervertebral disk on 20 adult cadaver spine specimens （L3-S1） were observed and measured. Results： ① The distance between the lateral border of inferior articular process and the root of spinous process of L3-L5 were （11.44± 1.67）, （14.67± 1.76） and （19.90± 1.70） mm respectively. ② The distance between the attachment point of ligamentum flavum to vertebral lamina and the inferior border of vertebral lamina of L3-L5 were （14.14±2.40）, （11.80±2.41） and （4.85±2.07） mm respectively. ③ The vertical dimension between the inferior border of L3-L5 vertebral lamina and the superior border of L3-L5 intervertebral disc was （11.56 ±2.07）, （9.25 ±2.82） and （0.51 ±3.12）mm respectively. ④ The vertical dimension between the superior border of L4-S1 vertebral lamina and the point of corresponding spinal nerve root leaving spinal dura mater were （5.27±1.66）, （-6.76±4.36） and （-12.35±4.94）mm respectively. ⑤ The vertical dimension between the point of L4-S1 nerve root leaving from spinal dura mater and the inferior border of L34-L5S1 intervertebral disk were （8.14±2.72）, （0.86±4.98） and （-8.61 ±3.39）mm respectively. ⑥ The vertical dimension between the point of L3-L5 nerve root leaving from spinal dura mater and the superior border of disk L3-4-L5S1 interverbrae were （11.14±2.80）, （13.30±3.81） and （18.42±4.51） mm respectively. Conclusions： It is valuable for low lumbar vertebrae discectomy through diskoscopic approach to understand detailed anatomic features of lumbar vertebrae.

关 键 词：下腰椎 椎间盘 椎间盘镜 应用解剖 

分 类 号：R323.33[医药卫生—人体解剖和组织胚胎学]