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基于磁共振的中国人斜向腰椎间融合的影像学解剖研究。

Imaging Anatomic Research of Oblique Lumbar Interbody Fusion in a Chinese Population Based on Magnetic Resonance.

机构信息

Department of Orthopedics, Affiliated Hospital of Nantong University, Jiangsu, China; Jiangsu Clinical Medicine Center of Tissue Engineering and Nerve Injury Repair, Jiangsu, China.

Department of Orthopedics, Northern Jiangsu People's Hospital, Jiangsu, China.

出版信息

World Neurosurg. 2019 Aug;128:e51-e58. doi: 10.1016/j.wneu.2019.03.244. Epub 2019 Apr 26.

Abstract

OBJECTIVE

To provide anatomic evidence of preoperative assessment of oblique lumbar interbody fusion (OLIF) for Chinese patients.

METHODS

From the hospital picture archiving and communication system, 400 lumbar magnetic resonance imaging studies of adults performed between November 2016 and January 2017 were selected. L2-3, L3-4, L4-5, and L5-S1 transverse and sagittal images were studied, and anatomic parameters associated with OLIF surgery, including bare window and psoas window, were measured and recorded. SPSS software was used for data summarization, sorting, and analysis to explore the significance of various anatomic parameters.

RESULTS

OLIF surgical corridors to the L2-S1 discs were found in most magnetic resonance imaging scans studied. The size of the psoas affects the difficulty of psoas muscle traction. It is relatively easy to perform OLIF surgery in older women. Most of the human iliac arteries were bifurcated and aggregated in front of the L4-5 intervertebral disc. The lower the aggregate level of the common iliac vein, the less likely it was to have the OLIF surgical corridor in the L5-S1 segment. The most frequently used lengths for a lumbar interbody cage for OLIF for Chinese patients are 50 mm and 55 mm.

CONCLUSIONS

OLIF can be a good choice for lumbar intervertebral fusion, including L5-S1 segment, in most Chinese patients. Older women are likely to have more scope of OLIF surgery. As a routine preoperative examination, lumbar magnetic resonance imaging is of great importance to OLIF surgery preoperative assessment.

摘要

目的

为中国患者提供斜侧腰椎体间融合术(OLIF)术前评估的解剖学依据。

方法

从医院的影像归档和通信系统中,选取了 2016 年 11 月至 2017 年 1 月间进行的 400 例成人腰椎磁共振成像研究。研究了 L2-3、L3-4、L4-5 和 L5-S1 的横断位和矢状位图像,并测量和记录了与 OLIF 手术相关的解剖学参数,包括裸窗和腰大肌窗。使用 SPSS 软件对数据进行汇总、排序和分析,以探讨各种解剖学参数的意义。

结果

在所研究的大多数磁共振成像扫描中,都发现了 OLIF 手术到达 L2-S1 椎间盘的通道。腰大肌的大小影响腰大肌牵引的难度。老年女性行 OLIF 手术相对容易。大多数人髂动脉在 L4-5 椎间盘前分叉聚集。髂总静脉的聚集水平越低,L5-S1 节段 OLIF 手术通道的可能性就越小。中国人行 OLIF 最常用的腰椎椎间融合器长度为 50mm 和 55mm。

结论

OLIF 可作为大多数中国患者腰椎融合术(包括 L5-S1 节段)的一种良好选择。老年女性更有可能有更多的 OLIF 手术范围。作为常规术前检查,腰椎磁共振成像对 OLIF 手术术前评估具有重要意义。

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