Teli Chandrika Gurulingappa, Kate Nilesh Netaji, Kothandaraman Usha
Assistant Professor, Department of Anatomy, Meenakshi Medical College and R.I. , Kanchipuram, Tamilnadu, India .
J Clin Diagn Res. 2013 Mar;7(3):422-6. doi: 10.7860/JCDR/2013/4763.2789. Epub 2013 Mar 1.
To reveal the variations of the iliolumbar artery and the iliolumabar veins and their correlation with the surrounding important structures.
We dissected the iliolumbar region bilaterally in 20 formalin-fixed adult cadavers. The diameter of the iliolumbar artery at its origin, its length up to the branching point, the distance between the iliolumbar artery and the inferior margin of the fifth lumbar vertebra and the distance between the iliolumbar artery and the bifurcation point of the common iliac artery, were measured. The pattern of drainage, the dimensions, the points of confluence with the common iliac vein and the obliquity of the iliolumbar vein were noted. The correlation between the iliolumbar artery and the veins to the obturator nerve and the lumbosacral trunk was recorded.
The iliolumbar artery originated from the posterior trunk of the internal iliac artery or from the internal iliac artery. The mean diameter of the iliolumbar artery, at its origin, was 3.5±0.5 mm. The mean distance between the origin of the iliolumbar artery and the bifurcation point to the iliac and the lumbar branches was 12.2±5.5 mm. The distance between the origin of the iliolumbar artery and the lower edge of the fifth lumbar vertebra was 43.2±11.6 mm. The distance between the origin of the iliolumbar artery and the bifurcation point of the common iliac artery was 38.7±10.6 mm. The mean distance of the iliolumbar veins from the inferior vena cava, overall, was 35± 9.9 mm. The mean width of the mouth of the iliolumbar vein was10.7 ± 5.1 mm and the mean angle of obliquity of the vein with respect to the long axis of the common iliac vein was 75.50. The tributaries which drained into the main iliolumbar vein were variable. The iliolumbar artery passed anterior in 70% and it passed posterior to the obturator nerve in 30%. The veins were lying anterior to the obturator nerve in 45% and they were lying posterior in 55%. The multiple tributaries which drained into the iliolumbar vein relation of the tributaries were variable, few passed anterior and few passed posterior. The iliolumbar artery was seen anterior to the lumbosacral trunk in 30%, it was posterior in 54%, it was cleaved in 8% and the branches of the artery were passing on either side of the lumbosacral trunk to enclose it like a clasp in 8%. The veins were anterior to the lumbosacral trunk in 40% and they were posterior in 60%.
The anatomical features of the iliolumbar artery, the iliolumbar veins and their correlation with the anatomical landmarks, which were presented here, would be helpful in decreasing the iatrogenic trauma to the neurovascular structures in the iliolumbar region.
揭示髂腰动脉和髂腰静脉的变异情况及其与周围重要结构的相关性。
对20具经福尔马林固定的成年尸体双侧髂腰区域进行解剖。测量髂腰动脉起始处的直径、至分支点的长度、髂腰动脉与第五腰椎下缘的距离以及髂腰动脉与髂总动脉分叉点的距离。记录引流模式、尺寸、与髂总静脉汇合点及髂腰静脉的倾斜度。记录髂腰动脉和静脉与闭孔神经及腰骶干的相关性。
髂腰动脉起自髂内动脉后干或髂内动脉。髂腰动脉起始处的平均直径为3.5±0.5毫米。髂腰动脉起始处至髂支和腰支分叉点的平均距离为12.2±5.5毫米。髂腰动脉起始处与第五腰椎下缘的距离为43.2±11.6毫米。髂腰动脉起始处与髂总动脉分叉点的距离为38.7±10.6毫米。髂腰静脉至下腔静脉的平均距离总体为35±9.9毫米。髂腰静脉口的平均宽度为10.7±5.1毫米，静脉相对于髂总静脉长轴的平均倾斜角度为75.5°。汇入髂腰静脉主干的属支各异。70%的髂腰动脉走行于前方，30%走行于闭孔神经后方。45%的静脉位于闭孔神经前方，55%位于后方。汇入髂腰静脉的多个属支关系各异，少数走行于前方，少数走行于后方。30%的髂腰动脉位于腰骶干前方，54%位于后方，8%被劈开，动脉分支从腰骶干两侧通过像夹子一样将其包围的占8%。40%的静脉位于腰骶干前方，60%位于后方。
本文所呈现的髂腰动脉和髂腰静脉的解剖特征及其与解剖标志的相关性，将有助于减少髂腰区域医源性神经血管结构损伤。
