关键词: XLIF, 生殖股神经, 应用解剖, 影像解剖

Abstract:

Objective　To investigate the position of genitofemoral nerve (GFN) in each vertebral space by dissection, then measure and calculate the data on lumbar magnetic resonance image to investigate GFN’s traveling position in the lumbar intervertebral space. Combined with the position of the great vessels and lumbar spinal nerve roots, the secure zone of each vertebral space in extreme lateral interbody fusion(XLIF) was located.　Methods　16 cases of adult cadavers were dissected, GFN’s position in the psoas major muscle and out the psoas major muscle was observed. The position of psoas major muscle and abdominal great vessels in 36 cases of lumbar magnetic resonance image was measured, the secure zone of XLIF approach in each vertebral space was analyzedand calculated.　Results　GFN was parabolic or nearly straight forward in the psoas major muscle, its position was above the line from its origin point in foramen to the point where it pierced out of the psoas major muscle. In samples that GFN pierce out of the psoas muscle at intervertebral space L3/4 or above, the distance from the posterior edge to GFN was (34.0±6.02)mm, and GFN was located in Zone A and I by Moro’s method. In samples that GFN exited the psoas muscle below intervertebral space L3/4, the distance from the posterior edge to GFN was not less than (16.0±2.16)mm, and GFN might be located in Zone I、II and III.　Conclusion　The security zone of XLIF approach at intervertebral space L2/3 is zone II and III, at intervertebral space L4/5 is Zone II. When GFN exitspsoas major muscle at intervertebral space L3/4 or above, the secure zone of XLIF approach at intervertebral space L3/4 is zone II. When GFN exits the psoas muscle below intervertebral space L3/4, approach from any zone at intervertebral space L3/4 has a chance to damage the blood vessels or nerve.

Key words: XLIF, GFN, Applied anatomy, Imaging anatomy