腰椎关节突关节区域静脉临床解剖学研究  

Clinical anatomy of the adjacent veins on lumbar zygapophyseal joints

作　　者：孙兆忠[1] 李瑞[1] 房清敏[1] 王光林[1] 张汉立[1] 邢建强[1] 

机构地区：[1]滨州医学院附属医院脊柱外科,滨州256603

出　　处：《滨州医学院学报》2015年第1期4-6,56,共4页Journal of Binzhou Medical University

基　　金：滨州市科技发展计划(2011ZC0920)

摘　　要：目的探讨关节突关节(zygapophyseal joints,ZJ)区域的静脉走行,以期了解腰椎ZJ区域静脉分布特点,为减少术中出血量及术后并发症提供解剖学依据。方法选取20具成人灌注尸体标本,显露腰椎侧方、后方及横突前方静脉,解剖显微镜下观测腰椎后方椎外后静脉丛、由椎管内穿出的椎间静脉、来自腰椎侧方的横突前静脉,以及注入的1-4腰静脉(Lumbar Vein,LV)和腰升静脉(Ascending Lumbar Vein,ALV),获得数据行统计学分析。结果 LV常出现单侧LV缺如,总出现率为69.38%(111/160)。椎外后静脉丛由后向前走行并分为内、外丛,在峡部中份表面的外径:L1(0.93±0.13)㎜<L2(1.01±0.21)㎜<L3(1.20±0.12)㎜<L4(1.24±0.16)㎜;椎旁静脉丛由外向内走行并汇合至横突前静脉,其外径对比:L1(1.06±0.24)㎜<L2(1.11±0.32)㎜<L3(1.17±0.24)㎜<L4(1.20±0.15)㎜;部分椎管内静脉行至椎间孔下缘时汇合形成椎间静脉,其外径对比L1(0.88±0.16)㎜<L2(0.90±0.10)㎜<L3(0.94±0.30)㎜<L4(0.95±0.31)㎜。两侧观察数据差异无统计学意义。结论 ZJ区域静脉的分布具有一定规律,了解其分布特点,可方便术中操作,减少术中出血,避免重要组织损伤,降低术后并发症的发生率。Objective Study the anatomical characteristic of adjacent veins on lumbar ZJ and provide academic basis to avoid vein bleeding and hematoma growing in lateral surgical approach ,endoscopic of lumbar .Methods We choose 20 adult human cadaver samples ,expose the veins beside lumbar vertebra and anterior of transverse process ,then observe the veins from L1A‐L4A at outlet area of L1/2-4/5 foramen intervertebrale .Measure external diameter of each branch rami dorsalis and describe the distribution and migratory route of adjacent veins on lumbar ZJ ,collect and analysis the data use statistical method .Results The occurrence rate of LV show 69 .38% （111/160） .The original location of dorsal branch usually at the anterosuperior of L1/2-4/5 foramen intervertebrale outlet area ,then distributed to the outside and backside of ZJ .there was no statistically sig‐nificant between left and right .Conclusion The route of veins adjacent to ZJ and the relationship between them show obvious regularity ,complications such as vein bleeding and hematoma would be avoided efficiently after grasping the anatomical charac‐teristic on them .

关 键 词：腰椎 关节突关节 静脉 临床解剖学 

分 类 号：R687.4[医药卫生—骨科学]