[1]姜平 赵学钢 李念虎△ 孔鹏 徐展望△ 贾梦龙 李森 叶敬尧.下胸椎横突间入路椎体间融合术的人体解剖学研究[J].中国中医骨伤科杂志,2019,27(12):9-12.
　JIANG Ping ZHAO Xuegang LI Nianhu KONG Peng XU Zhanwang JIA Menglong LI Sen YE Jingyao.Study on Human Anatomy of Lower Thoracic Interbody Fusion by Intertransverse Process Approach[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2019,27(12):9-12.
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下胸椎横突间入路椎体间融合术的人体解剖学研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第27卷
期数:
2019年12期
页码:
9-12
栏目:
实验研究
出版日期:
2019-12-04

文章信息/Info

Title:
Study on Human Anatomy of Lower Thoracic Interbody Fusion by Intertransverse Process Approach
文章编号:
1005-0205(2019)12-0009-04
作者:
姜平1; 2 赵学钢1 李念虎2△ 孔鹏2 徐展望2△ 贾梦龙1 李森1 叶敬尧1
1山东中医药大学(济南,250014) 2山东中医药大学附属医院
Author(s):
JIANG Ping1; 2 ZHAO Xuegang1 LI Nianhu2△ KONG Peng2 XU Zhanwang2△ JIA Menglong1 LI Sen1 YE Jingyao1
1Shandong University of Traditional Chinese Medicine,Jinan 250014,China; 2Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China.
关键词:
横突间入路;  下胸椎;  椎体间融合;  解剖
Keywords:
intertransverse approach;  lower thoracic vertebrae;  interbody fusion;  anatomy
分类号:
R-322
文献标志码:
A
摘要:
目的:在CT三维重建的影像学研究基础上,进行尸体解剖,研究下胸椎各横突间结构,进一步确认安全的手术入路及手术操作区域。方法:为模拟下胸椎横突间入路椎体间融合术的手术操作过程,对6具人体标本进行相应的解剖及操作,观察相关手术区域周围的解剖结构及相互间的空间关系,并进行椎间融合器、椎弓根螺钉置入操作。结果:下胸椎横突间入路椎间融合术手术操作可经胸最长肌与胸棘肌的间隙达到深层组织,并解剖横突间区域的组织结构,探寻周围神经、血管,并观察椎间孔外神经根、肋间后神经、肋间后动静脉的走行规律及彼此间的关系。之后顺利到达椎间隙,进行了Cage植入,并尝试模拟进行了同侧的椎弓根螺钉的置入。结论:人体标本的解剖对研究下胸椎横突间入路椎体间融合手术区域的解剖结构具有很好的应用价值。通过观察分析解剖结构并尝试同一切口附加单侧椎弓根钉固定,发现 T10/ T11和T11/ T12节段横突间区域较 T8/ T9和T9/ T10更加充分,神经根游离空间大且不易损伤周围血管,操作简单安全,更适合下胸椎横突间入路椎体间融合手术,从而明确了安全的手术操作区域,充分证实了该手术方式的安全性、可靠性及临床应用性。
Abstract:
Objective:Based on previous imaging studies of 3D reconstruction CT examination,autopsy was performed to study the intertransverse structures of the lower thoracic vertebra to further identify the safe surgical approaches and area of surgery.Methods:Six human specimens were dissected and operated accordingly to simulate the operation process of lower thoracic interbody fusion through transverse process approach.The anatomical structures and spatial relationships around the relevant surgical areas were observed,and the intervertebral fusion cage and the pedicle screw placement were performed during those procedures.Results:The operation of the lower thoracic interbody fusion through transverse process approach can reach deep tissue through the space between the longest pectoralis muscle and the pectoralis spinous muscle.The tissue structure of the intertransverse region can be dissected to explore the peripheral nerves and blood vessels to observe the travel rules of the external nerve roots of the intervertebral foramen,the intercostal nerve,the intercostal arteries veins,and the relationship between them.After that,access to the intervertebral space smoothly,the Cage implantation was carried out,and the placement of ipsilateral pedicle screw was attempted to be simulated.Conclusion:The anatomy of human specimens was of great value in studying the anatomical structure of lower thoracic interbody fusion through transverse process approach.By observing and analyzing the anatomical structure and attempting to attach the same incision with unilateral pedicle screw fixation,it was found that the segment between transverse process area in T10/T11 and T11/T12 were more fully than the T8/T9 and T9/T10,and nerve roots in free space was large enough to avoid the surrounding blood vessels injury.It was a simple and safe operation and was more suitable for the lower thoracic interbody fusion through transverse process.It revealed an identify the safe operation area for reliability and clinical applicability of the operation.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目:山东省自然科学基金面上项目(ZR2019MH044) 济南市科技计划项目(201401261) 山东省高等学校科技计划项目(J17KA242) 国家自然科学基金项目(81473709)△通信作者 E-mail:tigerlee073@126.com(收稿日期:2019-06-04)
更新日期/Last Update: 2019-12-04