腰神经根解剖及其在经皮穿刺腰椎间盘摘除术中的临床意义  

Anatomy of lumbar nerve root and its clinical significance on percutaneous lumbar diskectomy

作　　者：刘德隆[1] 田世杰[1] 苏庆军[1] 杨煦[1] 

机构地区：[1]北京市红十字朝阳医院骨科

出　　处：《临床骨科杂志》1999年第2期88-91,共4页Journal of Clinical Orthopaedics

摘　　要：目的加深对腰神经根周围解剖的认识，选择经皮穿刺最佳途径。方法对３０具成人尸体腰神经根周围结构进行解剖学观察、测量和摹拟穿刺。结果测量三角工作区面积（ｍｍ２）：Ｌ４～５为１０４６５±２３６６，Ｌ５～Ｓ１为９１８１±１６７８；直视下穿刺针进入角度（°）：Ｌ４～５为４５３３±１８１，Ｌ５～Ｓ１为４０４３±３４９，外区为４８４±２５６；穿刺点距后中线距离（ｍｍ）：Ｌ４～５为６９８±５７，Ｌ５～Ｓ１为６０６±７０，外区为９７１±９９；闭合穿刺成功率：Ｌ４～５为１００％，Ｌ５～Ｓ１为９０％，外区为６０％。结论经三角工作区穿刺是经皮后外侧入路腰椎间盘摘除术的最佳途径；对Ｌ５～Ｓ１间隙穿刺有困难时，可经三角工作区的外区进行穿刺手术。Objective To improve understanding of the local anatomy of lumbar nerve root and choose the best puncture approach. Methods We observed, surveyed and initiated puncture for the local anatomy of lumbar nerve root on 30 adult corpses. Results The area of the triangular working zone: L45 10465 mm22366 mm2, L5S19181 mm21678 mm2; the angle of puncture with direct vision: L45 4533181,L5,S1 4043349,and lateral zone: 484256; the distance between the point of pucture and middle line: L45 698 mm57 mm, L5S1606 mm70 mm, lateral zone 971 mm99 mm; the successful rate of puncture with close vision: L45 100% L5,S190% and lateral zone: 60%. WTHZConclusion Puncture into the triangular working zone is the best approach for the percutaneous posteriolateral diskectomy. L5S1, the lateral zone of the triangular working zone can be chosen in order to improve the rate of success.

关 键 词：腰神经根 椎间盘切除 外科解剖 

分 类 号：R687.4[医药卫生—骨科学] R602[医药卫生—外科学]