Ebraheim N A, Miller R M, Xu R, Yeasting R A
Department of Orthopaedic Surgery and Anatomy, Medical College of Ohio, Toledo 43699, USA.
Surg Neurol. 1997 Sep;48(3):232-6. doi: 10.1016/s0090-3019(96)00176-0.
Epidural fibrosis or scar formation is considered one cause of failed lumbar discectomy. Avoidance of unnecessary bony resection of the lamina may prevent or decrease postoperative scar formation. The knowledge of the precise location of the projection of the lumbar disc may also facilitate surgery and decrease patient morbidity. No studies exist regarding the projection of the lumbar disc on the posterior aspect of the lumbar spine.
Thirty-six whole lumbar spine specimens from L1 to L5 (180 lumbar vertebrae) and sacra were used for this study. Anatomic evaluation included the distance between the superior border of the vertebral body (inferior border of the intervertebral disc) and the superiormost margin of the lumbar lamina, and the distance between the inferior border of the vertebral body (superior border of the intervertebral disc) and the inferiormost margin of the lumbar lamina. The width of the interlaminar space was also measured.
The data showed that the level of the superior margin of the lamina was consistently inferior to the superior border of the corresponding vertebral body from L1 to S1. This distance for both sexes ranged from 10 to 11 mm for L1-L5 and 14 mm for S1. The level of the inferior margin of the lamina varied from 3 mm inferior to 9 mm superior to the inferior border of the corresponding vertebral body for L1-L5. The width of the interlaminar space averaged from 16.8 mm for L1 to 31.0 mm for L5.
This study suggests that the superior margin of the lamina represents a consistent, useful landmark in determining the location of the lumbar disc on the posterior aspect of the spine. The relationship between the inferior margins of the lamina and the vertebral body is not consistent.
硬膜外纤维化或瘢痕形成被认为是腰椎间盘切除术失败的原因之一。避免不必要的椎板骨质切除可能预防或减少术后瘢痕形成。了解腰椎间盘投影的确切位置也可能有助于手术并降低患者发病率。目前尚无关于腰椎间盘在腰椎后方投影的研究。
本研究使用了36个从L1至L5（共180个腰椎椎体）的完整腰椎标本以及骶骨。解剖学评估包括椎体上缘（椎间盘下缘）与腰椎椎板最上缘之间的距离，以及椎体下缘（椎间盘上缘）与腰椎椎板最下缘之间的距离。还测量了椎间隙的宽度。
数据显示，从L1至S1，椎板上缘水平始终低于相应椎体的上缘。L1-L5两性的这一距离范围为10至11毫米，S1为14毫米。L1-L5椎板下缘水平在相应椎体下缘下方3毫米至上方9毫米之间变化。椎间隙宽度从L1的平均16.8毫米到L5的31.0毫米不等。
本研究表明，椎板上缘是确定腰椎间盘在脊柱后方位置的一个一致且有用的标志。椎板下缘与椎体之间的关系并不一致。
