Kunakornsawat Sombat, Prasartritha Thavat, Korbsook Patipan, Vannaprasert Nuttapon, Tungsiripat Rachata, Tansatit Tanvaa
Department of Medical Services, Center of Excellence in Orthopedics, Lerdsin General Hospital, Bangkok, Thailand.
J Spinal Disord Tech. 2012 Dec;25(8):433-6. doi: 10.1097/BSD.0b013e31823c0fa0.
A cadaveric retrospective study.
To verify the variation of tributaries draining into the iliac system at the lumbosacral junction.
Special attention to vascular anatomy at the great venous bifurcation during anterior lumbar surgery is needed as more tributaries may increase the rate of operative bleeding. Although important, there have been very few detailed anatomic studies about variations of the ascending and iliolumbar veins. The latter tributary forms a horizontal system draining blood into the iliac vein.
A total of 116 formaldehyde-preserved specimens (61 male and 55 female) were studied. All specimens were dissected and simply classified into patterns and subpatterns according to the similar or different tributaries and their entry points.
There were 2 patterns of tributaries: symmetric and asymmetric. More variants were found in the asymmetric group. Each pattern comprising 58 specimens was further classified into 3 subpatterns according to their main tributary trunks. One to 3 tributaries may enter into any trunk of the iliac vein. The most common trunk was the common iliac vein seen in 75.9% of specimens. Draining into the external and internal veins was found in 21.6% and 2.6% of specimens, respectively. One common drainage of the ascending and iliolumbar veins on 1 or both sides was found in 0.9% and > 50% of specimens, respectively (right, 51.7%; left, 56%), whereas 2 or more tributaries were seen in < 50% of specimens (right, 47.4%; left, 43.1%). There was no significant statistical difference among sexes and body sides.
Draining into the iliac system has a high frequency of variations through a number of tributaries and their entry points. The iliolumbar vein will mainly drain into the common iliac vein with frequently 2 or 3 tributaries, whereas drainage into the external iliac or the internal vein is less often observed.
尸体回顾性研究。
验证腰骶关节处汇入髂静脉系统的支流变异情况。
腰椎前路手术时，在大静脉分叉处需特别关注血管解剖结构，因为更多的支流可能会增加手术出血率。尽管重要，但关于升静脉和髂腰静脉变异的详细解剖学研究却非常少。后者形成一个水平系统，将血液引流至髂静脉。
共研究了116个用甲醛保存的标本（61例男性和55例女性）。所有标本均进行解剖，并根据支流及其汇入点的相似或不同简单分类为模式和子模式。
支流有两种模式：对称和不对称。不对称组发现更多变异。每种模式包含58个标本，根据其主要支流主干进一步分为3个子模式。1至3条支流可汇入髂静脉的任何主干。最常见的主干是在75.9%的标本中可见的髂总静脉。分别在21.6%和2.6%的标本中发现汇入髂外静脉和髂内静脉。在0.9%和>50%的标本中分别发现一侧或两侧升静脉和髂腰静脉有一个共同引流（右侧，51.7%；左侧，56%），而在<50%的标本中可见2条或更多支流（右侧，47.4%；左侧，43.1%）。性别和身体两侧之间无显著统计学差异。
通过多个支流及其汇入点汇入髂静脉系统的变异频率很高。髂腰静脉主要汇入髂总静脉，通常有2或3条支流，而汇入髂外静脉或髂内静脉的情况较少见。
