Rodríguez-Sanz Jacobo, Borrella-Andrés Sergio, López-de-Celis Carlos, Albarova-Corral Isabel, Pérez-Bellmunt Albert, Bueno-Gracia Elena, Malo-Urriés Miguel
Faculty of Medicine and Health Science of Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallés, Spain.
ACTIUM Functional Anatomy Group, 08195 Sant Cugat del Vallès, Spain.
J Clin Med. 2024 Jul 28;13(15):4411. doi: 10.3390/jcm13154411.
Approximately 40% of chronic low back pain patients have a discogenic origin. In relation to intervertebral disc injuries, most of them are in the posterior and lateral zone of the disc, involving the anterior lumbar roots and the spinal cord. : The objective was to analyze and describe the accuracy and safety of a new ultrasound-guided approach to target the posterolateral part of the intervertebral lumbar discs in cadaveric specimens. : A cross-anatomical study on sixty cadaver intervertebral lumbar discs was performed. A needle was introduced in the posterolateral part of the discs using ultrasound guidance. A transducer was placed in the anterior abdomen to visualize the discs in cross-section as well. A dissection of the specimen was performed to visualize the final position of the needle tip and its distance from the main lumbar structures. The angulation, length, and distance of the needle from the vertebral spine, the relevant ultrasound anatomical references, and the accuracy of the procedure were evaluated. : The needle tip reached the posterolateral part of the discs in 93.3% of the attempts. The mean length of the needle inserted was 79 ± 15 mm, the angulation 129 ± 20.2°, the distance from the spinous process was 77 ± 19 mm, and the distance of the needle to the nerve roots was 2.0 ± 1.2 mm. No statistically significant differences between genders were found. : An ultrasound-guided technique can be an accurate and safe technique to perform invasive procedures on the posterolateral part of the intervertebral lumbar discs.
约40%的慢性下腰痛患者病因源于椎间盘。关于椎间盘损伤，其中大多数位于椎间盘的后外侧区域，累及腰前根和脊髓。目的是分析和描述一种新的超声引导方法在尸体标本中靶向腰椎间盘后外侧部分的准确性和安全性。对60个尸体腰椎间盘进行了横断面解剖研究。在超声引导下将针插入椎间盘的后外侧部分。将换能器置于前腹部以横断面观察椎间盘。对标本进行解剖以观察针尖的最终位置及其与主要腰椎结构的距离。评估了针的角度、长度、与脊椎的距离、相关超声解剖参考以及该操作的准确性。在93.3%的尝试中，针尖到达了椎间盘的后外侧部分。插入针的平均长度为79±15毫米，角度为129±20.2°，与棘突的距离为77±19毫米，针与神经根的距离为2.0±1.2毫米。未发现性别之间存在统计学上的显著差异。超声引导技术可以是一种对腰椎间盘后外侧部分进行侵入性操作的准确且安全的技术。
