摘要
目的:测量与经骶前间隙轴向腰骶椎间融合(AxiaLIF)入路相关的解剖学和影像学数据,探讨国人该入路的安全性。方法:(1)成人尸体标本20具,男8具,女12具,年龄26～86岁,平均56岁,在S1/2间隙水平线上测量骶骨中线至髂内动、静脉和骶中动脉的距离及直肠系膜的厚度,计算最靠近中线的左右髂血管间的距离。(2)120例腰痛患者,男46例,女74例,年龄18～90岁,平均53岁,在其腰骶椎MRI正中矢状面上测量骶骨前缘至直肠系膜的最短距离。骶前间隙的前后向最短距离和最靠近中线的左右髂血管间距离构成AxiaLIF工作通道的"操作空间"。结果:同一性别左、右侧同名血管到骶骨中线的距离均无显著性差异(P>0.05),最靠近骶骨中线的髂血管均为髂内静脉,左右髂内静脉间的距离即"操作空间"横径男性为5.8±0.5(5.1～6.4)cm,女性为6.3±0.4(5.6～7.0)cm,男性与女性比较有显著性差异(P<0.05);骶中动脉位置有变异;直肠系膜厚度为0.3￣0.5cm。在MRI上测量,男性骶骨前缘到直肠系膜的最短距离的中位数为1.0(0.3～2.3)cm,女性为0.6(0.3～1.8)cm,男性与女性比较有显著性差异(P<0.01)。结论:国人在经骶前间隙AxiaLIF入路中放置直径1.2cm的工作套管是安全的。
Objective：To investigate some correlated data with a approach via the presacral space for axial lumbosacral interbody fusion （AxiaLIF） in order to evaluate the safety of the axial access technique in Chinese adult.Method：（1）The distance from the sacral midline at the Sl/2 level to the middle sacral artery,internal iliac arteries and veins;and the thickness of the mesorectum were measured in 20 human cadaveric specimens （8 men, 12 women）,with average age of 56 years ranging from 26 to 86 years.The distance from the most medial of the right internal iliac vessels to the most medial of the left internal iliac vessels was calculated.（2）MR images of the lumbosacral vertebrae were obtained from 120 patients with lower back pain （46 men,74 women）,with average age of 53 years ranging from 18 to 90 years.The shortest distance from the anterior margin of the sacrum to the mesorectum was measured on median sagittal plane.（3）A ＂operating space＂ for setting up a working channel for AxiaLIF was determined using the shortest sagittal length of the presacral space and the distance between the most medial internal iliac vessel on the right and left respectively.Result：There were no difference in the distance between the sacral midline at the S1/2 level and the homonymic vessels on the right and left both in male and female respectively（P〉O.05）.The most medial internal iliac vessels on the right and left were all the internal iliac veins and the mean distance （transverse diameter viz. ＂operating space＂） in men and women was 5.8±0.5cm（range 5.1-6.4cm） and 6.3±0.4cm（5.6- 7.0cm） ,respectively.There was significant difference between the data of male and female groups （P〈0.05 ）.The middle sacral artery was found variable in its location.The mean thickness of the mesorectum was 0.4±0.1cm （range 0.3-0.5cm）.The distance between the anterior sacral margin to the mesorectum was significantly larger in male group than that in female group[median 1.0cm（range 0.3-2.3cm） vs 0.6cm（range 0.3-1.8cm）, （P〈 0.01）].Conclusion：It is sale to insert a 1.2cm diametric working pipe in the presacral approach for AxiaLIF in Chinese adult.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2008年第5期381-384,I0001,共5页
Chinese Journal of Spine and Spinal Cord
关键词
腰骶椎
椎间融合
解剖学
MRI
骶前间隙
Lumbosacral vertebra
Spinal fusion
Anatomy
MRI ：Presacral space
