基于MRN技术的下腰椎Kambin三角的解剖学研究

doi:10.13418/j.issn.1001-165x.2022.3.05

Abstract

Abstract: Objective To measure and analyze the anatomical data of magnetic resonance neurography (MRN) of lower lumbar Kambin triangle working area in normal adults, so as to provide reference for the selection and safety evaluation of minimally invasive surgery of lower lumbar spine. Methods Twenty healthy adult volunteers (male: 10, female: 10) were performed magnetic resonance imaging scan at L4~S1 segment with 3.0 T MRN. The neuroimaging was performed by OsiriX software. The following data were measured: the distance between ganglion and superior pedicle (A), the distance between ganglion and lower pedicle (B), and the angle between nerve root and dural sac (α), area of Kambin triangle (S). Finally, the measured data were statistically analyzed. Results From L4 to S1 segment, the distance between ipsilateral ganglion and superior pedicle decreased gradually (P<0.05). But there was no statistical difference between ipsilateral ganglion and lower pedicle (P>0.05). From L4 to S1, the angle between ipsilateral outlet nerve root and dural sac gradually decreased, the difference was statistically significant (P<0.05). From L4 to S1, the area of Kambin triangle increased gradually (P<0.05). In addition, there was no statistical difference between the left and right sides of the same segment (P>0.05). Conclusions MRN technology can clearly and accurately visualize the anatomical relationship of the Kambin triangle structures of the lower lumbar spine, which is helpful to measure the relevant anatomical data and can guide the selection of minimally invasive surgical methods and the evaluation of surgical safety.

Key words: Kambin triangle, , , Magnetic resonance neuroimaging, , , Anatomical structure, , , Lumbar minimally invasive surgery

CLC Number:

R323.43

Wang Hongwei , Li Kaixiang, Wang Qingyun, Li Ruibing, Liu Xiaoqiang. Anatomical study of lower lumbar Kambin triangle based on MRN technique[J]. Chinese Journal of Clinical Anatomy, 2022, 40(3): 267-270.

References 15

[1]	袁仕国, 李义凯, 王华军, 等. 腰椎间孔侵入性操作的应用解剖[J]. 中国临床解剖学杂志, 2010, 28(2): 127-130. DOI: 10.7666/d.y1997338.
[2]	王一丹, 许阳阳, 苏宝科, 等. 经皮椎间孔镜技术治疗腰椎疾病的研究进展[J]. 中国临床解剖学杂志, 2020, 38(4): 488-491. DOI: 10.13418/j.issn. 1001-165x.2020.04.024.
[3]	马国骏, 张建军, 赵秋枫, 等. 磁共振3D神经成像对腰骶丛显示的对比研究[J]. 医学影像学杂志, 2016, 26(7): 1157-1159. CNKI: SUN:XYXZ.0.2016-07-002.
[4]	Khadilkar S, Deshmukh ND, Shah NH, et al. Optimizing investigations for evaluation of enlargements of the roots, plexuses and nerves: a study of 133 patients[J]. Ann Indian Acad Neurol, 2020, 23(5): 666-673. DOI: 10.4103/aian.AIAN_504_19.
[5]	王浩, 赵星丞, 陈秋, 等. 经皮椎间孔镜下椎间盘切除治疗腰椎间盘突出症的效果[J]. 临床骨科杂志, 2020, 23(4): 506-509. DOI: 10.15887/j.cnki.13-1389/r.2020.12.071.
[6]	Fanous AA, Tumialán LM, Wang MY. Kambin's triangle: definition and new classification schema[J]. J Neurosurg Spine, 2019, 32: 390-398. DOI: 10.3171/2019.8.SPINE181475.
[7]	König A, Joseph F, van Rensburg JC, et al. Kambin's triangle and the position of the dorsal nerve root in the lumbar neural foramen[J]. Clin Anat, 2020, 33(8): 1204-1213. DOI: 10.1002/ca.23565.
[8]	张明, 郑祖根. 腰椎神经根管狭窄神经根受压的形态学变化及其临床意义[J]. 中国临床解剖学杂志, 2002, 20(2): 109-111. DOI: 10.3969/j.issn.1001-165X.2002.02.010.
[9]	Attar A, Ugur HC, Uz A, et a1. Lumbar pedicle: surgical anatomic evaluation and relationships[J]. Eur Spine, 2001, 10(1): 10-15. DOI: 10.1007/s005860000198.
[10]	朱爱国, 陈云, 张烽, 等. 腰骶丛三角工作区的应用解剖及临床意义[J]. 中国组织工程研究, 2016, 20(53): 7946-7951. DOI: 10.3969/j.issn.2095-4344.2016.53.006.
[11]	Xie PG, Feng F, Chen ZH, et al. Percutaneous transforaminal full endoscopic decompression for the treatment of lumbar spinal stenosis[J]. BMC Musculoskelet Disord, 2020, 21(1): 546. DOI: 10.1186/s12891-020-03566-x.
[12]	Howe FA, Filler AG, Bell BA, et al. Magnetic resonance neurography[J]. Magn Reson Med, 1992,28(2): 328-338. DOI: 10.1002/mrm. 1910280215.
[13]	Onder H, Goksungur G. The utility of neuroimaging parameters in discriminating patients of normal-pressure hydrocephalus with positive cerebrospinalfluid tap test response from healthy controls[J]. Ann Indian Acad Neurol, 2020, 23(5): 625-631. DOI: 10.4103/aian.AIAN_583_19.
[14]	Hiscox LV, Schwarb H, McGarry MDJ, et al. Aging brain mechanics: progress and promise of magnetic resonance elastography[J]. Neuroimage, 2021,232:117889. DOI: 10.1016/j.neuroimage. 2021. 117889.
[15]	王敏, 赵庆豪, 苏志海, 等. 基于CT/MRI融合建立的Kambin三角三维模型与标本测量的对比研究[J]. 中国脊柱脊髓杂志, 2019, 29(1): 67-73. DOI: 10.3969/j.issn.1004-406X.2019.01.11.

Anatomical study of lower lumbar Kambin triangle based on MRN technique

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References 15

Related Articles 15

Metrics

Comments

Recommended 0

[1]	Jiang Jianhong, Duan Renpeng, Li Xiaofeng. Application of three-dimensional visualization technology in the anatomical variations of hilar bile ducts in Chinese population [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 1-4.
[2]	Guo Hongzhi, Wang Yu, Zhang Jiaqi, Liang Haibin, Ma Ziwei, Feng Wei, Wu You, Si Ziyi. Evaluation of placental vascular structure in preeclampsia by vascular casting combined with CT three-dimensional model [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 5-10.
[3]	Li Jiawei, Zhang Jing, Li Canran, Lan Wenjie, Ji Qingyu, Guo Zhiyong, Zhang Yunfeng, Liu Qi, Chen Qingwei, Li Xiaohe. X-ray measurement of proximal femur anatomical parameters in Mongolian population [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 11-16.
[4]	. Digital measurement and clinical significance of occipitocervical Angle and posterior occipitocervical Angle in children and adolescents [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 17-20.
[5]	Li Wen, Yang Siyi, Huang Lei, Qing Jiwen, Jiang Songtao, Zhang Lei. Morphological characteristics and clinical significance of Lisfranc ligament based on MRI [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 21-25.
[6]	Li Fanfan, Xu Yang, Wang Xiaoxu. Therapeutic effect of shikonin on the treatment of granuloma lobular mastitis in model rats by regulating Nrf2/HO-1 signaling pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 26-32.
[7]	Wang Xinghang, Ding Jiayuan, Li Fang, Bao Cuifen, Yan Lijing. Ginsenoside Rg1 reduces the inflammatory response of microglia after oxygen glucose deprivation/resupply by inhibiting the NLRP3 inflammasome pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 33-41.
[8]	Cheng Yingying, Wu Jianjun, Cai Haiyan , Jiao Xunwen, Ma Jiangbo, Ding Yinxiu. Activation and functional changes of astrocytes cultured in vitro under inflammatory stimulation [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 42-46.
[9]	Qi Zhi, Yang Li, Jia Qiuye, Chen Haolun, Duan Zhaoda, Wu Chunyun. Edaravone regulates Sirt3 expression in lipopolysaccharide-activated microglia via MAPKs signaling pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 47-53.
[10]	Zhang Jingjing, Wang Hongxin. Protective effect of Baicalin on rats with pulmonary hypertension through PDGF/P38 MAPK signaling pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 54-58.
[11]	Yue Qin, Chen Rongli, Xiong Jingxi, Wang Tingyi, Cai Zhiheng, Yi Qiushi, Zeng Xinyi. Effect of Bletilla striata polysaccharides on the choke-area of cross-boundary flap in rats [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 59-64.
[12]	Li Xiaoyu , Zhang Lei , Fu Lei , Li Dongbo , Wang Guoyou. Finite element study on the treatment of Sanders type II calcaneal fracture with three-step reduction method [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 65-70.
[13]	Wu Yanfei, Ma Jianxiong, Lu Bin, Wang Ying, Bai Haohao, Jin Hongzhen, Ma Xinlong. Study on the correlation between the reconstruction of grayscale values using CT post-processing technology and the compressive strength of the endplate [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 71-76.
[14]	Zhuang Wanqiang, Tang Yi, Luo Yonggang, Zhang Hui. An early and mid-term retrospective study of the effects of arthroscopy combined with high tibial osteotomy on patellar position and patellofemoral joint function [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 77-82.
[15]	Luo Ying, Dou Weiyu, Wu Xiaohang, Chen Jingkun, Peng Changgui, Pan Jianying . Risk factors of postoperative complications of calcaneal fractures treated with hippocampal plate internal fixation through minimally invasive method [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 83-88.