脊柱胸腰段椎内静脉丛的应用解剖学研究  

Applied anatomy study of inner vertebral canal venous plexus of thoracolumbar

作　　者：敖俊[1] 兰美兵[2] 薛鹏举[1] 覃建朴[1] 季文军[1] 廖文波[1] 

机构地区：[1]遵义医学院附属医院脊柱外科,贵州遵义563003 [2]遵义医学院珠海校区人体解剖教研室,广东珠海519090

出　　处：《中国现代医学杂志》2013年第28期29-32,共4页China Journal of Modern Medicine

基　　金：贵州省科学技术基金(No:黔科合J字[2010]2179号);遵义医学院博士科研启动基金(No:遵医院办发[2010]19号)

摘　　要：目的研究胸腰段(T11~L2)脊椎椎弓根内侧的椎管内静脉丛特点,为经椎管椎体内植骨手术治疗爆裂骨折操作减少出血提供解剖学依据。方法观测18具经防腐处理的成人尸体标本脊柱胸腰段椎弓根内侧的椎管内静脉丛的走行和分布特点。结果前丛在椎弓根内侧最突出处与后纵韧带外缘宽由上至下逐渐增大,约(3.28±0.43)^(4.46±0.23)mm之间,前丛横行吻合支宽度在(10.23±0.26)^(17.22±0.28)mm之间,在后纵韧带下方,亦由上至下逐渐增宽;椎静脉前丛及横行吻合血管腹侧为滋养孔结构,位于椎体后壁中间部,越靠中线越密集,孔径越大。在椎弓根内缘与椎板交界处的椎管内静脉丛后丛主要为后窦结构,直径(1.45±0.23)^(1.73±0.38)mm之间。结论脊柱胸腰段椎弓根内侧的椎管静脉丛结构主要有前丛、前丛横吻合支和后窦。在此范围内,需根据各静脉丛的位置和解剖特点进行针对性操作,可以减少对椎内静脉丛的损伤,减少术中出血。[ Objective ] To investigate the anatomic characteristics of the thoracolumbar segment inner vertebral canal venous plexus for reducing bleeding in the process of bone grafting in injured vertebral body through vertebral canal for thoracolumbar fracture operation and provide the anatomical basis. [Methods] The 18 adult embalmed corpse specimen of thoracolumbar section were collected and their venous plexus distribution characteristics which located at pedicle medial were observed. [ Results ] The anterior inner vertebral venous plexus gradually increased from top to bottom between the most prominent of pedicle medial and posterior longitudinal ligament, whose width ranged from （3.28＋0.43） mm to （4.46_＋0.23） mm. The transverse branches height of anterior inner vertebral venous plexus gradually increased from top to bottom too, which located under posterior longitudinal ligament and width ranged from （10.23-＋0.26） mm to （17.22_＋0.28） mm. Before anterior inner vertebral venous plexus and transverse trans- verse branch ventral was the nourish pores, located in vertebral posterior wall in the middle, more on the Midline more intensive, aperture is wide. There was posterior sinus of posterior inner vertebral venous plexus around the junction of pediele medial and lamina, between（1.45-＋0.23） mm and （1.73_＋0.38） mm in diameter. [ Conclusions] There are anteri- or inner vertebral venous plexus, transverse branch and posterior sinus at the pedicle medial of thoracolumbar vertebra canal. In this range, according to each position of venous plexus and anatomical features for targeted operation can re- duce the damage venous plexus inner vertebral canal and intra operative hemorrhage.

关 键 词：胸腰椎 椎管 静脉丛 应用解剖 

分 类 号：R323.3[医药卫生—人体解剖和组织胚胎学]