正常成年人胸腰椎椎间孔的解剖形态学研究。
Anatomic morphological study of thoracolumbar foramen in normal adults.
机构信息
School of Postgraduates of Inner Mongolia Medical University, Hohhot, China.
Human Anatomy of Inner Mongolia Medical University, Hohhot, China.
出版信息
Folia Morphol (Warsz). 2021;80(3):675-682. doi: 10.5603/FM.a2020.0107. Epub 2020 Sep 8.
BACKGROUND
Based on computed tomography images of the thoracolumbar intervertebral foramen and its surrounding parameters, and analysing the intervertebral foramen morphology and the correlation between the measured parameters, to provide an anatomical basis for clinical minimally invasive transvertebral surgery.
MATERIALS AND METHODS
Ten fresh adult cadaveric specimens (32-50 years old) with bilateral (T1-S1) spinal segments were selected for a total of 20 sides, a total of 340 intervertebral foramens and were measured with vernier callipers in the Department of Anatomy, Inner Mongolia Medical University. The intervertebral foramen height, the minimum sagittal diameter of the foramen, the width of the spinal ganglion, the sagittal diameter of the spinal ganglion and the sagittal diameter of the intervertebral foramen were measured. This study was reviewed and approved by the local Ethics Committee.
RESULTS
The results of the minimum sagittal diameter of the T9-10~L5/S1 intervertebral foramen were (6.93 ± 1.99) mm, (7.33 ± 1.44) mm, (7.41 ± 0.63) mm, (6.85 ± 1.08) mm, (6.79 ± 1.86) mm, (7.82 ± 3.25) mm, (8.23 ± 2.27) mm, (9.17 ± 2.33) mm, (8.38 ± 1.63) mm; the average height of the T2/3 to L5/S1 intervertebral space was (4.82 ± 1.88) mm, (3.95 ± 0.80) mm, (4.04 ± 0.52) mm, (4.26 ± 0.78) mm, (4.39 ± 1.16) mm, (5.15 ± 1.59) mm, (5.51 ± 1.49) mm, (5.97 ± 2.60) mm, (7.13 ± 2.07) mm, (8.94 ± 1.37) mm, (9.01 ± 1.47) mm, (11.63 ± 1.63) mm, (14.20 ± 1.37) mm, (14.22 ± 2.33) mm, (14.22 ± 2.33) mm, (13.32 ± 1.37) mm intervertebral foramen height, intervertebral foramen minimum sagittal diameter, spinal ganglion width, spinal ganglion sagittal diameter. P > 0.05 for comparison of the left and right sides of the intervertebral space, with no statistically significant difference. L4/5, L5/S1 segment left and right bilateral contrast with the middle height of the vertebral space p < 0.05, the difference is statistically significant. The remaining segments left and right bilaterally contrasted p > 0.05, and the difference was not statistically significant.
CONCLUSIONS
The minimum height of intervertebral foramen in the thoracolumbar segment was T6/7, and L1/2 was the minimum height in the lumbar segment. When placing a spinal endoscopic working channel safely into intervertebral foramen, it is necessary to perform an enlarging foraminoplasty to reduce the risk of injury to the exiting nerve root.
背景
基于胸腰椎椎间孔及其周围参数的 CT 图像，分析椎间孔形态及各测量参数间的相关性，为临床微创经椎间孔脊柱手术提供解剖学依据。
材料与方法
选取内蒙古医科大学解剖学教研室 10 具（32-50 岁）新鲜成人尸体标本双侧（T1-S1）脊柱节段共 20 侧，共 340 个椎间孔，用游标卡尺测量椎间孔高度、最小矢状径、椎间孔内脊神经节宽度、脊神经节矢状径、椎间孔矢状径。本研究经当地伦理委员会审查和批准。
结果
T9-10L5/S1 椎间孔最小矢状径分别为（6.93±1.99）mm、（7.33±1.44）mm、（7.41±0.63）mm、（6.85±1.08）mm、（6.79±1.86）mm、（7.82±3.25）mm、（8.23±2.27）mm、（9.17±2.33）mm、（8.38±1.63）mm；T2/3L5/S1 椎间孔平均高度分别为（4.82±1.88）mm、（3.95±0.80）mm、（4.04±0.52）mm、（4.26±0.78）mm、（4.39±1.16）mm、（5.15±1.59）mm、（5.51±1.49）mm、（5.97±2.60）mm、（7.13±2.07）mm、（8.94±1.37）mm、（9.01±1.47）mm、（11.63±1.63）mm、（14.20±1.37）mm、（14.22±2.33）mm、（14.22±2.33）mm、（13.32±1.37）mm；椎间孔最小矢状径、椎间孔高度、脊神经节宽度、脊神经节矢状径，左右两侧比较差异均无统计学意义（P>0.05）。L4/5、L5/S1 节段左右两侧对比椎间孔中部高度差异有统计学意义（P<0.05）。其余各节段左右两侧对比差异无统计学意义（P>0.05）。
结论
胸腰椎段椎间孔最小高度为 T6/7，腰椎段最小高度为 L1/2。安全置入脊柱内镜工作通道时，需要进行椎间孔扩大成形术，以降低对走行神经根损伤的风险。
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