脊柱内镜技术处理腰椎关节突关节毗邻出口神经根伴随动脉的解剖学应用研究  

Anatomic Application of Spinal Endoscopy in the Treatment of Adjacent Outlet Nerve Root and Accompanying Artery of Lumbar Facet Joint

作　　者：苗莹莹 张浩平 王斌 李宽宽 MIAO Ying-ying;ZHANG Hao-ping;WANG Bin;LI Kuan-kuan(Department of Human Anatomy,Sanquan College of Xinxiang Medical University,Xinxiang 453002,China;Intervertebral Disc Center,the Third People's Hospital of Henan Provincial,Zhengzhou 450002,China;Department of Biochemistry and Molecular Biology,Sanquan College of Xinxiang Medical University,Xinxiang 453002,China)

机构地区：[1]新乡医学院三全学院人体解剖学教研室,新乡453003 [2]河南省直第三人民医院椎间盘中心,郑州450002 [3]新乡医学院三全学院生物化学与分子生物学教研室,新乡453003

出　　处：《四川解剖学杂志》2024年第1期1-3,17,共4页Sichuan Journal of Anatomy

基　　金：2021年度河南省科技厅科技攻关项目(212102310681);2021年河南省高等学校骨于教师培养计划项目(2021GGJS200);新乡医学院三全学院学术技术带头人计划项目(SQ2023XSJSDTR02)。

摘　　要：目的:探讨脊柱内镜技术处理腰椎关节突关节毗邻出口神经根伴随动脉的解剖学应用.方法:选择新鲜人体标本男、女各5具为研究对象.采取剥离显露腰椎脊柱及关节突关节周围组织结构方法,观察该区域血管形态、走行规律及与周围毗邻组织关系.结果:腰椎关节突关节毗邻出口神经根处血管网与内镜工作通道,或者环锯距离,在L3/4节段,男性为(11.39±0.72)mm,女性为(11.03±0.52)mm;在L4/5节段,男性为(11.78±1.26)mm,女性为(11.29±0.38)mm;在L5/S1节段,男性为(11.1±0.98)mm,女性为(10.45±0.45)mm.在男、女性的L3/4、L4/5及L5/S1节段中,该出口神经根处血管网与内镜工作通道或者环锯的距离左、右两侧比较,差异均无统计学意义(P>0.05).结论:采取人体尸体标本解剖研究,从开放角度探讨关节突关节毗邻出口神经根伴随动脉的走行与周围组织的关系,可指导施术者术中穿刺及工作通道置入,降低甚至避免术中出血量或术后血肿发生率.Objective:To explore anatomical research on the application of spinal endoscopy technology in the treatment of adjacent outlet nerve roots and accompanying arteries of lumbar facet joints.Method:A total of 10 fresh human cadaver specimens were selected as the research subjects,they were 5 male and 5 female,respectively.Through anatomical research on human cadaver specimens,explore the relationship between the shape of blood vessels adjacent to the articular process joint and surrounding tissues from an open perspective,dissect and expose the tissue structure around the lumbar spine and facet joints,observe the morphology and shape of blood vessels in this area,and their relationship with adjacent tissues.Results:The distance between the vascular network at the outlet nerve root and the endoscopic working channel or circular saw were(11.39+0.72)mm for males and(11.03±0.52)mm for females at L3/4 segment;At L4/5 segment,they were(11.78±1.26)mm for males and(11.29+0.38)mm for females;At the L5/S1 segment,they were(11.1±0.98)mm for males and(10.45+0.45)mm for females.In both males and females,there was no statistically significant difference in the distance between the vascular network at the outlet nerve root and the endoscopic working channel or circular saw on either side(P>0.05).Conclusion:Using human cadaver specimens for anatomical research,exploring the relationship between the adjacent outlet nerve roots of the articular process joint and the accompanying arteries and surrounding tissues from an open perspective can guide the intraoperative puncture and insertion of working channels for the surgeon。

关 键 词：脊柱内镜 腰椎关节突关节 脊神经根 脊髓血管 解剖学 

分 类 号：R68[医药卫生—骨科学]