Department of Spinal Surgery, General Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China.
Department of Spine Surgery, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing, China.
PLoS One. 2019 Mar 5;14(3):e0213164. doi: 10.1371/journal.pone.0213164. eCollection 2019.
To observe the regional anatomy of the lumbar artery (LA) associated with the extrapedicular approach applied during percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP), we collected 78 samples of abdominal computed tomography angiography imaging data. We measured the nearest distance from the center of the vertebral body puncture point to the LA (distance VBPP-LA, DVBPP-LA). According to the DVBPP-LA, four zones, Zone I, Zone II, Zone III and Zone IV, were identified. LAs that passed through these zones were called Type I, Type II, Type III and Type IV LAs, respectively. A portion of the lumbar vertebrae had an intersegmental branch that originated from the upper segmental LA and extended longitudinally across the lateral wall of the pedicle; it was called Type V LA. Compared with the DVBPP-LA in L1, L2, L3 and L4, the overall difference and between-group differences were significant (P < 0.05). In L1, L2, L3, L4 and L5, there were 8, 4, 4, 0 and 1 Type I LAs, respectively. There were no Type V LAs in L1 and L2, but there were 2, 16 and 26 Type V LAs in L3, L4 and L5, respectively. In L1-L5, the numbers of Type I LA plus Type V LA were 8, 4, 6, 16 and 27, and the presence ratios were 5.1%, 2.6%, 5.6%, 10.3% and 17.3%, respectively. In L4 and L5, the male presence ratios of Type I LA plus Type V LA were 7.1% and 10.7%, respectively, and the female presence ratios were 13.9% and 25.0%, respectively. Thus, extrapedicular PVP (PKP) in lumbar vertebrae had a risk of LA injury and was not suggested for use in L4 and L5, especially in female patients.
为了观察经皮椎体成形术（PVP）和经皮后凸成形术（PKP）应用过程中经皮椎弓根外入路相关的腰动脉（LA）的区域解剖，我们收集了 78 例腹部 CT 血管造影成像数据。我们测量了椎体穿刺中心点到 LA 的最近距离（距离 VBPP-LA，DVBPP-LA）。根据 DVBPP-LA，将其分为 4 个区，Zone I、Zone II、Zone III 和 Zone IV。穿过这些区域的 LA 分别称为 Type I、Type II、Type III 和 Type IV LA。部分腰椎有发自上位节段 LA 的节段间分支，沿椎弓根外侧壁纵向延伸，称为 Type V LA。与 L1、L2、L3 和 L4 的 DVBPP-LA 相比，总体差异和组间差异均有统计学意义（P < 0.05）。在 L1、L2、L3、L4 和 L5，分别有 8、4、4、0 和 1 个 Type I LA。L1 和 L2 没有 Type V LA，但 L3、L4 和 L5 分别有 2、16 和 26 个 Type V LA。在 L1-L5，Type I LA 加 Type V LA 的数量分别为 8、4、6、16 和 27，存在率分别为 5.1%、2.6%、5.6%、10.3%和 17.3%。在 L4 和 L5，男性 Type I LA 加 Type V LA 的存在率分别为 7.1%和 10.7%，女性的存在率分别为 13.9%和 25.0%。因此，腰椎经皮椎弓根外 PVP（PKP）有 LA 损伤风险，不建议在 L4 和 L5 中使用，尤其是在女性患者中。
