L1-L5 水平椎管外放射状韧带的形态学及其可能的临床意义。
Morphology and Possible Clinical Significance of the Radiating Extraforaminal Ligaments at the L1-L5 Levels.
机构信息
Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Science, Southern Medical University, Guangzhou, China.
Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
出版信息
Spine (Phila Pa 1976). 2017 Sep 15;42(18):1355-1361. doi: 10.1097/BRS.0000000000002120.
STUDY DESIGN
A dissection-based study of 10 fresh-frozen human cadavers.
OBJECTIVE
The objective of this study was to identify and describe the radiating extraforaminal ligaments in the exit regions of the L1-L5 intervertebral foramina and to research their possible clinical significance.
SUMMARY OF BACKGROUND DATA
The transforaminal ligaments at the L1-L5 intervertebral foramina have been well studied. However, detailed descriptions of the radiating extraforaminal ligaments at L1-L5 are lacking.
METHODS
Eighty L1-L5 intervertebral foramina from 10 fresh cadavers were studied, and the extraforaminal ligaments were identified. The quantity, morphology, origin, insertion, and spatial orientation of the extraforaminal ligaments in the L1-L5 regions were examined. The length, width, diameter, and thickness of the ligaments were measured using a vernier caliper.
RESULTS
A total of 224 extraforaminal ligaments were identified in the 80 L1-L5 intervertebral foramina, and the occurrence rate of extraforaminal ligaments was 100%. One hundred and eighteen (52.68%) of the extraforaminal ligaments were radiating ligaments, and 106 (47.32%) of the extraforaminal ligaments were transforaminal ligaments. There were 97 (43.30%) ligaments at the superior aspect of the exit regions of the intervertebral foramina, 51 (22.77%) ligaments at the anterior aspect, 44 (19.64%) ligaments at the inferior aspect, and 32 (14.29%) ligaments at the posterior aspect. The morphologies of the extraforaminal ligaments were divided into two types: the strap type and the trabs type.
CONCLUSION
Radiating extraforaminal ligaments exist between spinal nerves and nearby structures. Radiating extraforaminal ligaments may be of clinical importance to surgeons. Dissecting the radiating extraforaminal ligaments before percutaneous endoscopic lumbar discectomy may be an important step in reducing postoperative pain, which may result in significant benefits for patients.
LEVEL OF EVIDENCE
研究设计
基于 10 具新鲜冷冻人体尸体的解剖研究。
目的
本研究旨在识别和描述 L1-L5 椎间孔出口区域的辐射性椎间外韧带，并研究其可能的临床意义。
背景资料概要
L1-L5 椎间孔的经椎间韧带已得到充分研究。然而，对于 L1-L5 的辐射性椎间外韧带的详细描述却很少。
方法
对 10 具新鲜尸体的 80 个 L1-L5 椎间孔进行研究，并识别椎间外韧带。检查 L1-L5 区域椎间外韧带的数量、形态、起源、插入和空间方位。使用游标卡尺测量韧带的长度、宽度、直径和厚度。
结果
在 80 个 L1-L5 椎间孔中总共识别出 224 条椎间外韧带，椎间外韧带的发生率为 100%。118 条（52.68%）椎间外韧带为辐射状韧带，106 条（47.32%）椎间外韧带为经椎间韧带。出口区域的椎间孔上方有 97 条（43.30%）韧带，前方有 51 条（22.77%）韧带，下方有 44 条（19.64%）韧带，后方有 32 条（14.29%）韧带。椎间外韧带的形态分为两种类型：带型和 trabs 型。
结论
辐射性椎间外韧带存在于脊神经和附近结构之间。辐射性椎间外韧带可能对外科医生具有重要的临床意义。在经皮内窥镜腰椎间盘切除术之前解剖辐射性椎间外韧带可能是减少术后疼痛的重要步骤，这可能会为患者带来显著的益处。
证据水平
3 级。
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