成人脊髓圆锥的位置  

The position of conus medullaris in Chinese adult population

作　　者：庞磊[1] 孔博玉[2] 仇金鹏[1] 路璐[3] 麻海春[1] 

机构地区：[1]吉林大学第一医院麻醉科,长春市130021 [2]吉林大学第一医院放射科,长春市130021 [3]吉林大学第一医院乳腺外科,长春市130021

出　　处：《中华麻醉学杂志》2010年第6期690-691,共2页Chinese Journal of Anesthesiology

摘　　要：目的 确定成人脊髓圆锥的位置,以避免腰麻穿刺时损伤脊髓.方法 腰腿痛病人800例,年龄18～91岁,采用Siemens 1.5 T磁共振成像系统进行成像,正中矢状面上脊髓最远一点所对应的椎体或椎间盘为脊髓圆锥末端的位置.结果 190例病人脊髓圆锥末端位置位于L1.2间隙以下.随年龄段的增加,脊髓圆锥末端位于L1.2间隙以下的发生率升高（P＜0.05）.结论 常规临床采用L2,3间隙进行蛛网膜下腔穿刺时应慎重,建议腰麻病人术前应该作CT或MRI确定脊髓圆锥位置,以避免蛛网膜下腔穿刺时损伤脊髓.Objective To investigate the variation in the position of conus medullaris in Chinese adult population in order to avoid hitting conus during spinal puncture. Methods Eight hundred patients suffering from back pain, aged 18-91 yr, were enrolled in this study. The position of conus medullaris was determined using Siemens 1.5 T magnetic resonance imaging system. According to the method described by Reimann, the vertebral body was used as mark of reference to the level of the end of conus. Results There were 190 patients in whom the position of the end of conus medullaris was lower than L1,2 . The incidence of the position of the end of conus medullaris lower than L1,2 was higher in patients 30-60 or older than in those under 30, and in those over the age of 60 than in those 30-60 （P 〈 0.05）. Conclusion Spinal puncture should be performed cautiously at L2,3. CT or MRI is recommended before operation for the patients to locate the position of conus medullaris and avoid injury to the spinal cord.

关 键 词：脊髓 解剖学 手术中并发症 

分 类 号：R614[医药卫生—麻醉学]