腰椎间孔镜的应用解剖

doi:10.13418/j.issn.1001-165x.2017.01.002

Abstract

Abstract:

Objective　To provide data for transforaminal endoscopic lumbar surgery at different levels.　Methods　Anatomic structures, including the height of intervertebral foramens,the morphology of safety triangle of intervertebral foramen and safety triangle of spinal canal on 10 adult cadaver spine specimens (L1～S1) were observed and measured.　Results　①The vertical dimension between the intersection of a horizontal line drawn through the middle of disc space and the tip of the safety triangle of intervertebral foramen and the exiting nerve root at L1/2～L5/S1 were (4.75±0.80), (6.42±0.44), (7.30±0.82),(7.74±0.52) and (4.68±1.27) mm; ② The distance between the intersection of a horizontal line drawn through the middle of posterior margin of disc and the vertical line drawn through the medial one third of the pedicle and the exiting nerve root at L1/2～L5/S1 were (4.02±0.78), (4.67±0.65), (5.17±0.91), (6.16±0.74) and (5.48±0.61) mm; ③ The distance between the intersection of a horizontal line drawn through the middle of posterior margin of disc and the vertical line drawn through the medial one third of the pedicle and the thecal sac/traversing nerve root at L1/2~L5/S1 were (3.89±0.61), (4.39±0.71), (5.17±0.97), (6.58±0.70) and (6.22±1.20)mm.　Conclusions　Understanding detailed anatomic features of lumbar vertebrae is valuable for choosing a suitable working cannula during transforaminal endoscopic lumbar surgery.

Key words: Lumbar vertebrae, Safety triangle, Transforaminal endoscopic, Applied anatomy

WU Bo1, ZHAO Qing-hao2, ZHOU Xiao-qi1, SHI Ben-chao1, PENG Yan-kai1, CHEN Zhong1, DING Zi-hai2. Applied anatomy for transforaminal endoscopic lumbar surgery[J]. Chinese Journal Of Clinical Anatomy, 2017, 35(1): 5-8.

References

[1] 赵伟, 李长青, 周跃, 等. 经皮椎间孔镜下TESSYS技术治疗腰椎间盘突出症[J]. 中国矫形外科杂志, 2012, 20(13):1191-1195.
[2] 柳百炼, 熊鹰, 顾邵, 等. 经皮椎间孔镜治疗腰椎间盘突出症的临床效果[J]. 实用医学杂志, 2015, 319(6):981-983.
[3] Gadjradj PS, van Tulder MW, Dirven CM, et al. Clinical outcomes after percutaneous transforaminal endoscopic discectomy for lumbar disc herniation:a prospectivecase series[J]. Neurosurg Focus, 2016, 40(2):1-7.
[4] Kim CH, Chung CK, Sohn S, et al. The surgical outcome and the surgical strategy of percutaneous endoscopic discectomy for recurrent disk herniation[J]. J Spinal Disord Tech, 2014, 27(8):415-422.
[5] Kambin P, O'Brien E, Zhou L, et al. Arthroscopic microdiscectomy and selective Fragmentectomy[J]. Clin Orthop Relat Res, 1998, (347): 150-167.
[6] Mirkovic SR, Schwartz DG, Glazier KD, et al. Anatomic considerations in lumbar posterolateral percutaneous procedures [J]. Spine, 1995, 30(18): 1965-1971.
[7] Park JW, Nam HS, Cho SK, et al. Kambin's triangle approach of lumbar transforaminal epidural injection with spinal stenosis[J]. Ann Rehabil Med, 2011, 35(6):833-843.
[8] 何尚宽, 徐达传, 王义生, 等. 经皮穿刺L5～S1椎间盘髓核摘除入路的应用解剖[J]. 中国临床解剖学杂志, 1993, 11(3):168-170.
[9] Deen H. Posterolateral endoscopic excision for lumbar disc herniation:surgical technique, outcome, and complications in 307 consecutive cases[J]. Spine, 2002, 27(18):2081-2082．
[10]Ruetten S, Komp M, Merk H, et al. Full-endoscopic interlaminarand transforaminal lumbar discectomy versus conventional microsurgical technique:a prospective, randomized, controlled study[J]. Spine, 2008, 33(9):931-939．
[11]白一冰, 徐岭, 赵文亮, 等. 经皮腰椎间孔镜手术的穿刺定位策略[J]. 中国微创外科杂志, 2012，12(6):540-543.
[12]Ahn Y, Lee H, Lee S, et al. Dural tears in percutaneous endoscopic lumbar discectomy[J]. Eur Spine J, 2011, 20(1):58-64．

[1]	Chen Ren, Yang Shengbo. Research progress on the anatomy and clinical application of masseter muscle [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 115-117.
[2]	Wu Wenbin, Hu Yutian, Dai Linxi, Lv Wangxuan, Lv Fengjun, Yin Yuanjie, Yang Hongmeng, Chang Junda, Li Wenqi, Guo Yiwei. Applied anatomical study of anesthesia in vertebral ganglia [J]. Chinese Journal of Clinical Anatomy, 2023, 41(6): 640-646.
[3]	Bai Jiyue, Xu Yongqing. Anatomical research of selective peripheral neurotomy in the treatment of cerebral palsy [J]. Chinese Journal of Clinical Anatomy, 2023, 41(6): 754-756.
[4]	He Ailing, Wang Qing, Li Guangzhou. CT imaging anatomical study of lumbar vertebral basivertebral foramen in elderly patients with osteoporotic vertebral compression fractures [J]. Chinese Journal of Clinical Anatomy, 2023, 41(3): 283-287.
[5]	He Xiaoqing, Yang Xi, Shi Yan, Xu Yuexian, Fang Xiang, Fan Xinyu, Wu Yaling, Xu Yongqing. Anatomical study and clinical significance of superficial lateral sural artery perforator flap [J]. Chinese Journal of Clinical Anatomy, 2023, 41(2): 132-136.
[6]	Chen Shuai, Yi Chenpeng, Wang Jie, Gong Dawei, Jiao Feng, Huang Huayang, Zheng Xiaofei, Wang Haibin. Anatomical study and clinical significance on tibial collateral ligament of the knee and medial meniscus [J]. Chinese Journal of Clinical Anatomy, 2022, 40(5): 519-522.
[7]	Zhu Mingsheng, Wang Zengtao, Chen Jingguo, Hao Liwen, Chen Chao, Hou Zhidian. Anatomical study and clinical significance of the first metacarpal artery ulnar perforator branch of metacarpal neck [J]. Chinese Journal of Clinical Anatomy, 2022, 40(3): 249-254.
[8]	Zhou Jiayu, Zhou Guoyan, Yang Shengbo. Localization and significance of nerve entry points of the anterior forearm muscles in adults [J]. Chinese Journal of Clinical Anatomy, 2022, 40(2): 126-131.
[9]	Wang Shaohe, Fan Hongbin, Shi Guanqi, Chen Yangshu, Gao Di, Jin Zhewu, Wang Zhen, Du Bin, Hu Yibo, Wu Ke. Applied anatomical study of the lateral stability of proximal interphalangeal joint by the injury of proximal phalanx trochlea [J]. Chinese Journal of Clinical Anatomy, 2021, 39(6): 635-637.
[10]	Liu Xingli, Du Zihong , Zhang Xiangmin, Yin Junkun, Fu Dujuan, Li Zhi, Lv Liang. The anatomical study of superficial vein in right cubital fossa based on vascular instrument [J]. Chinese Journal of Clinical Anatomy, 2021, 39(3): 269-275.
[11]	Zhao Wentao, Zhao Min. Applied anatomy study of zoneⅠ extensor terminal tendon insertion and its adjacent tissues [J]. Chinese Journal of Clinical Anatomy, 2021, 39(2): 126-129.
[12]	Sun Shizhu, Yu Shengbo, Sui Hongjin. Application of the P45 sectional plastination technique in applied anatomic study [J]. Chinese Journal of Clinical Anatomy, 2021, 39(2): 240-243.
[13]	TIAN Wei-dong, PENG Long-feng, ZHU Shao-lei, WANG Xiao-wen . Applied anatomical relationship between cerebellar artery and trigeminal nerve root [J]. Chinese Journal of Clinical Anatomy, 2020, 38(6): 625-628.
[14]	CHEN Wei-dong, QIAN Lei, QU Dong-bin, He Shan-li, LI Ze-yu, TAN Wei-hao, ZHONG Jin-tao, Yang Hang, OU-YANG Jun, ZHENG Ming-hui. Anatomical study on puncture depth of thoracic paravertebral nerve block [J]. Chinese Journal of Clinical Anatomy, 2020, 38(5): 545-548.
[15]	JIANG Hua-cai, LONG Li, LI Sen. Applied anatomy and clinical efficacy of high ilioinguinal approach in the treatment of tile C-type pelvic fractures [J]. Chinese Journal of Clinical Anatomy, 2020, 38(4): 471-475.

Applied anatomy for transforaminal endoscopic lumbar surgery

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Comments

Recommended 0