下腰椎侧方入路中静脉及神经的应用解剖学研究及临床意义  

Applied Anatomic Study of Vein and Nerve for Lateral Approach of Lower Lumbar and Its Clinical Significance

作　　者：孙兆忠[1] 房清敏[1] 仲江波[1] 邢建强[1] 王光林[1] 窦永峰[1] 张汉立[1] 耿晓鹏[1] 王大巍[1] 

机构地区：[1]山东省滨州医学院附属医院脊柱外科,滨州市256603

出　　处：《中国骨与关节损伤杂志》2010年第11期975-977,共3页Chinese Journal of Bone and Joint Injury

基　　金：山东省医药卫生科技发展计划基金资助项目(2007HZ041)

摘　　要：目的研究下腰椎侧方入路中静脉、神经的应用解剖学特点,为该手术入路提供解剖学依据。方法显微镜下观测21具成人尸体标本髂腰静脉（iliolumbar veins,ILV）、腰升静脉（ascending lumbar vein,ALV）及L5、S1神经根前支、腰交感干的走行及与周围结构的毗邻关系。结果ILV和ALV缺失率高,形态学变异较大;L5神经根前支紧贴骶骨翼前方走行,位置恒定;骶骨岬前外侧缘到第1骶前孔上缘切线的垂直距离为（28.73±2.93）mm;L3-S1椎间孔前上缘到腰交感干的垂直距离分别为（27.21±2.04）mm、（27.40±2.11）mm、（26.89±2.33）mm。结论下腰椎侧方静脉、神经的走行及解剖学形态具有一定规律性,在下腰椎侧方手术入路中,可有效避开或牵开这些结构,避免术中损伤。Objective To study anatomic characteristics of veins and nerves and provide anatomic data for lower lumbar lateral surgical approach.Methods Twenty-one human cadavers were investigated to record the course and relationship of surrounding structure iliolum-bar veins,ascending lumbar vein,anterior branch of L4 and L5 nerve roots and lumbar sympathetic trunk.Results The absence ratios were high and varied greatly of morphology of ILV and ALV,anterior branch of L5 nerve root was coursed on the surface of ala sacralis and the location was relatively consistent.The vertical dimension of anterolateral border of cochlear of sacral bone to superior border of first anterior sacral foramina was（28.73±2.93）mm,the vertical dimensions of anterosuperior border of intervertebral foramen of L3～S1 to lumbar sympathetic trunk were（27.21±2.04）mm,（27.40±2.11）mm,（26.89±2.33）mm.Conclusion The course,distribution and anatomic mor-phology of lateral veins and nerves of lower lumbar have unvarying regularity,so the lateral approach of lower lumbar could efficiently get out of the way or these anatomic structures to avoid intraoperative injuries.

关 键 词：下腰椎 侧方入路 静脉 神经 应用解剖 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]