中国临床解剖学杂志 ›› 2019, Vol. 37 ›› Issue (4): 361-365.doi: 10.13418/j.issn.1001-165x.2019.04.001

• 应用解剖 •    下一篇

腰椎椎间静脉的形态学研究及其临床意义

苏志海1, 赵庆豪2, 王敏1, 刘恩情2 , 刘斌1, 丁自海3, 吕海1   

  1. 1. 中山大学附属第五医院脊柱外科,  广东   珠海   519000; 2. 南方医科大学第三附属医院骨科,  广州    510630;
    3. 南方医科大学微创外科解剖学研究所, 广东省医学生物力学重点实验室,  广州   510515
  • 收稿日期:2018-06-26 出版日期:2019-07-25 发布日期:2019-07-31
  • 通讯作者: 吕海,主任医师,博士生导师,Tel: 18665000036,E-mail: 18665000036@qq.com
  • 作者简介:苏志海(1993-),硕士,医师,研究方向:脊柱微创解剖研究,E-mail: 13265092954@163.com
  • 基金资助:
    广东省广州市天河区科技项目(201604KW012);广东省广州市科技计划项目(201704020033)

Morphological study of lumbar intervertebral veins and its clinical significance

SU Zhi-hai1, ZHAO Qing-hao2, WANG Min2, LIU En-qing2, LIU Bin2, DING Zi-hai3, LV Hai1   

  1. 1. Department of Spine Surgery, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000,Guangdong Province; 2. Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou 510630; 3. Anatomical Institute of Minimally Invasive Surgery of Southern Medical University, Guangdong Provincial key laboratory of Medical Biomechanics Guangzhou 510515, China
  • Received:2018-06-26 Online:2019-07-25 Published:2019-07-31

摘要: 目的 研究腰椎椎间静脉的解剖结构及其临床意义。  方法 观察12具防腐的腰椎标本两侧椎间静脉属支的走行、分布及其与神经根的关系,并测量其外径以及长度。其静脉外径以及长度由观察者反复采用游标卡尺(精确度0.01 mm)测量所得。  结果 腰椎椎间静脉在12具标本中120个椎间孔内均存在。根据其属支在椎间孔内的走行、分布及其与神经根的关系,大致可以分4种类型。199条腰椎椎间静脉的外径平均为(2.13±0.58)mm,最大外径为4.16 mm。  结论 腰椎椎间静脉是腰椎比较重要的解剖结构,当椎间孔镜技术在安全三角操作时,可能会导致椎间静脉的破裂。应注意椎间静脉的存在,提前结扎或者术中充分止血,有可能会降低术后神经感觉迟钝等相应并发症的发生。对于脊柱微创手术医生,充分了解掌握腰椎椎间静脉的解剖结构有一定的临床辅导意义。

关键词: 腰椎,  椎间静脉,  椎间孔镜,  安全三角,  解剖

Abstract: Objective To study the anatomy and clinical significance of lumbar intervertebral veins.  Methods 12 embalmed cadavers were dissected to observe the tributaries and distribution of the lumbar intervertebral vein, and their relationship with nerve roots in the intervertebral foramina. The diameter and length of branches of the lumbar intervertebral vein were measured by the Vernier caliper (accuracy 0.01 mm). Results    The branches of the intervertebral veins could be observed in all the 120 intervertebral foramina of 12 embalmed cadavers. According to the distribution and distribution of tributaries of the lumbar intervertebral vein, and their relationship with nerve roots can be divided into four types. The average diameter of 199 branches of the lumbar intervertebral veins was (2.13±0.58) mm and the maximum outer diameter was 4.16 mm.     Conclusions    The lumbar intervertebral veins are an important anatomical structure of the lumbar spine. When percutaneous transforaminal endoscopic disscectomy is performed in the safe triangle area, it may lead to the rupture of the intervertebral veins. Attention should be paid to the presence of the intervertebral veins, and early ligation or adequate hemostasis should be performed during operation, which may reduce postoperative complications such as nerve insensitivity. For minimally invasive spine surgeons, understanding of the anatomy of the lumbar intervertebral veins adequately may have some clinical implications.

Key words: Lumbar vertebrae; The intervertebral veins; Transforaminal endoscopic; Safe triangle; ,  ,  Anatomy 

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