Schellinger D, Manz H J, Vidic B, Patronas N J, Deveikis J P, Muraki A S, Abdullah D C
Department of Radiology, Georgetown University Medical Center, Washington, DC 20007.
Radiology. 1990 Jun;175(3):831-6. doi: 10.1148/radiology.175.3.2343133.
This report analyzes the most frequently observed migration paths of disk fragments in 47 patients who had extruded or sequestered disks. Observations are based principally on magnetic resonance (MR) images. When disk fragments moved in a superior (42%) or inferior (40%) direction from the donor disk, the displaced disk components were most frequently (94%) dislodged into the right or left half of the anterior epidural space (AES) and rarely straddled the midline. To explain this phenomenon, the authors investigated the anatomy of the AES by dissecting four cadaver specimens and reviewing 300 MR images of the spine. They conclude that the migrating path of a disk fragment is determined by the anatomy of the AES, a fairly well-defined space delimited posteriorly by the posterior longitudinal ligament and by membranes laterally attached to it. It consists of two compartments separated by a sagitally aligned septum. During migration, sequestered disk fragments usually stay in these compartments.
本报告分析了47例椎间盘突出或游离患者中最常观察到的椎间盘碎片迁移路径。观察主要基于磁共振（MR）图像。当椎间盘碎片从供体椎间盘向上（42%）或向下（40%）移动时，移位的椎间盘成分最常（94%）进入前硬膜外间隙（AES）的右侧或左侧半区，很少跨越中线。为了解释这一现象，作者通过解剖4个尸体标本并回顾300张脊柱MR图像，研究了AES的解剖结构。他们得出结论，椎间盘碎片的迁移路径由AES的解剖结构决定，AES是一个界限相当明确的空间，其后部由后纵韧带界定，侧面由附着于其上的膜界定。它由两个由矢状排列的隔膜分隔的腔室组成。在迁移过程中，游离的椎间盘碎片通常停留在这些腔室内。
