Kagami Yujiro, Nakashima Hiroaki, Satake Kotaro, Ito Kenyu, Tsushima Mikito, Segi Naoki, Tomita Hiroyuki, Ouchida Jun, Morita Yoshinori, Ode Yukihito, Imagama Shiro, Kanemura Tokumi
Department of Orthopedic Surgery, Konan Kosei Hospital, Konan 483-8704, Japan.
Department of Orthopedic Surgery, Anjo Kosei Hospital, Anjo 446-8602, Japan.
J Clin Med. 2023 Apr 21;12(8):3041. doi: 10.3390/jcm12083041.
The current study aimed to investigate the anatomical position of the gonadal veins (GVs) from the viewpoint of spine surgery and the risk factors associated with lateral lumbar interbody fusion (LLIF).
This retrospective study included 99 consecutive patients. The GV locations were divided into the ventral (V), dorsal medial (DM), and dorsal lateral (DL) sides based on lumbar disk levels on axial contrast-enhanced computed tomography images. The DM region surrounded by the vertebral body and psoas muscle had the highest risk of GV injury. The GV at each intervertebral disk level was examined in terms of laterality and sex. The patients were divided into group M (which included those with GV in the DM region at any vertebral level) and group O (which included those without GV in the DM region at any vertebral level). Then, the two groups were compared.
In the case of lower lumbar levels and in women, the GVs were commonly observed in the DM region. Group M had a higher incidence of degenerative scoliosis than group O and a significantly larger Cobb angle.
We should pay close attention to the GV location on the preoperative image when using LLIF, particularly in female patients with degenerative scoliosis.
本研究旨在从脊柱外科手术的角度探讨性腺静脉（GVs）的解剖位置以及与腰椎侧方椎间融合术（LLIF）相关的危险因素。
这项回顾性研究纳入了99例连续的患者。根据轴向增强CT图像上的腰椎间盘水平，将GVs的位置分为腹侧（V）、背内侧（DM）和背外侧（DL）。椎体和腰大肌所包围的DM区域发生GV损伤的风险最高。对每个椎间盘水平的GVs进行了左右侧别及性别的检查。患者被分为M组（包括在任何椎体水平的DM区域有GVs的患者）和O组（包括在任何椎体水平的DM区域均无GVs的患者）。然后，对两组进行比较。
在腰椎较低节段以及女性患者中，GVs常见于DM区域。M组退行性脊柱侧凸的发生率高于O组，且Cobb角明显更大。
在使用LLIF时，我们应在术前影像上密切关注GVs的位置，尤其是患有退行性脊柱侧凸的女性患者。
