Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
Spine (Phila Pa 1976). 2022 Nov 15;47(22):E617-E624. doi: 10.1097/BRS.0000000000004458. Epub 2022 Aug 11.
Observational study using retrospective contrast-enhanced computed tomography (CT) analysis.
This study aimed to investigate the anatomical characteristics and variations of the thoracic segmental arteries.
Few cadaver studies of segmental arteries to the thoracic spine have been reported; however, no previous studies have reported the use of contrast-enhanced CT in the upper to middle thoracic spine. Detailed anatomical information of the thoracic segmental arteries is essential to avoid vascular injuries in thoracic spine surgery, such as in the anterior and posterior approaches and minimally invasive surgery.
Patients who underwent CT angiography of the thoracic spine between 2012 and 2021 were retrospectively analyzed. The pathways of the thoracic segmental arteries were reviewed. Anatomical differences depending on the vertebral level and right/left segmental arteries were investigated.
Thirty-one patients (15 men and 16 women; mean age 55.8 yr) with 591 segmental arteries were surveyed. The distribution of segmental arteries differed depending on the vertebral level, which ran more longitudinally in the upper thoracic region and transversely in the lower thoracic region. Common trunks were frequently observed in the segmental arteries of T3-5. Segmental arteries frequently crossed the disks in the right anterior and left middle areas of the thoracic spine, whereas in the T4/5 disks, segmental arteries crossed the disks over a wide area. The presence of multiple segmental arteries within a single vertebra was higher at the T5-7 vertebral level.
The distribution of the segmental arteries was asymmetrical and varied depending on the vertebral level. In the upper to middle thoracic, segmental arteries ran at every position of the vertebral body due to their longitudinal nature and the presence of multiple segmental arteries within a single vertebra, especially in T5-7. The results of this study provide critical information for thoracic spine surgery.
回顾性对比增强计算机断层扫描（CT）分析的观察性研究。
本研究旨在探讨胸段节段动脉的解剖特征和变异。
仅有少数关于胸段节段动脉的尸体研究报告，但尚无先前研究报告使用对比增强 CT 对中上胸椎进行研究。详细的胸段节段动脉解剖信息对于避免胸椎手术中的血管损伤至关重要，如前路和后路以及微创手术。
回顾性分析了 2012 年至 2021 年间接受胸椎 CT 血管造影的患者。审查了胸段节段动脉的路径。研究了根据椎体水平和左右节段动脉的解剖学差异。
共调查了 31 名患者（15 名男性和 16 名女性；平均年龄 55.8 岁）的 591 个节段动脉。节段动脉的分布因椎体水平而异，在上胸段呈更纵向分布，在下胸段呈横向分布。在 T3-5 的节段动脉中经常观察到共同干。节段动脉在右前和左中胸椎间盘处经常穿过椎间盘，而在 T4/5 椎间盘处，节段动脉穿过椎间盘的区域较宽。在 T5-7 椎体水平，单个椎体内存在多个节段动脉的情况更高。
节段动脉的分布不对称，且随椎体水平而变化。在上中胸段，由于节段动脉的纵向性质和单个椎体内存在多个节段动脉，节段动脉可在椎体的各个位置运行，尤其是在 T5-7。本研究的结果为胸椎手术提供了重要信息。
