内镜下侧方入路单椎体内固定治疗胸腰椎压缩性骨折的解剖学研究  

Anatomical study of only injured vertebrae internal fixation through lateral approach by endoscope to treat thoracolumbar vertebral compression fracture

作　　者：李际才[1] 刘平均[1] 刘君华[1] 贺用礼[1] 毛炳焱[1] 王文聪[1] 晏平华[1] 丁原[1] 胡志喜[1] 

机构地区：[1]湖南省常德市石门县人民医院(长沙医学院附属石门医院)骨科,415300

出　　处：《中国医疗前沿》2012年第21期5-6,共2页China Healthcare Innovation

基　　金：湖南省卫生厅科技基金资助项目(编号:B2009134)

摘　　要：目的探讨内镜下侧方入路单椎体内固定术治疗胸腰椎压缩性骨折在应用解剖上的可行性。方法随机选取12具脊柱胸腰段保存完整的成人尸体标本,垂直于矢状面将克氏针钻入T11-L4椎体侧方中央,观察脊神经的走行方向、冠状面上各克氏针与其后方经过的上位脊神经的距离、胸腰段椎体节段血管在椎体侧方的走行位置、椎体高度、椎体后缘与腔静脉、主动脉的距离,测量椎体侧方手术安全区。结果冠状面上T10-L3脊神经均走行于下位椎体侧方中线(克氏针)的后方,胸腰段椎体节段性血管紧贴椎体侧方自内上斜向外下走向,本手术路径无法避开,胸腰椎侧方存在手术安全区,左侧手术区较右侧更安全。结论内镜下侧方入路单椎体内固定治疗胸腰椎压缩性骨折在解剖学上是可行性的。Objective To investigate the feasibility of treatment thoracolumbar vertebral compression fracture by endoscopic lateral approach which only injured vertebrae internal fixated. Methods Select 12 thoracolumhar vertebrae with adult corpses specimens randomly, perpendicular to the vertical plane a gram needle drilling into the TH-L4 vertebral body side in central, observe the nerve way of T,0-L3, coronary face every gram its rear after superior needle of the distance and chest pairs of vertebral segment lumbar blood vessels in the vertebral body side walk line position, thoracolumbar vertebral height, after vertebral bodies flanges and vena cava, aortic distance, calculation vertebral lateral surgical area safety. Results Coronary face T,o-L3 nerve walking on lateral vertebral bodies under a line（gram needle） rear, segment artery of thoracolumbar vertebrae cling to the body, this surgery path can＇t avoid it, vertebral lateral side being security operation window, the left is right safety. Conclusion Minimal invasion through lateral approach by endoscopic treatment thoracolumbar vertebral compression fracture in anatomical means is feasibility.

关 键 词：胸腰椎 压缩性骨折 单椎体 内固定 应用解剖 

分 类 号：R681.5[医药卫生—骨科学]