椎基静脉孔及椎体静脉解剖在椎体成形术中的意义

王素春,施建东,陆爱清,王志荣,张烽

中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (6) : 646-650.

中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (6) : 646-650. DOI: 10.13418/j.issn.1001-165x.2015.06.007
断层影像解剖

椎基静脉孔及椎体静脉解剖在椎体成形术中的意义

  • 王素春1, 施建东1, 陆爱清1, 王志荣1, 张烽2
作者信息 +

Anatomic distribution of basivertebral foramen and vertebral vein in vertebral bodies of T8~L5 and its clinical significance in PVP and PKP

  • WANG Su-chun1, SHI Jian-dong1,  LU Ai-qing1, WANG Zhi-rong1, ZHANG Feng2
Author information +
文章历史 +

摘要

目的 为胸腰椎(T8~L5)椎体成形术减少骨水泥渗漏等并发症提供解剖学依据。  方法 对40例健康成人胸腰椎螺旋CT薄层扫描和重建,观察每节段正中矢状位和横断位图像上椎基静脉孔(basivertebral foramen, BF)和椎体静脉孔道(vertebral vein, VV)出现的频率;测量椎体正中矢状径(VD)和BF宽(BFW)、深(BFD)高(BFH);测量BF距椎体左右缘距离(VW1和VW2)和距上下终板的距离(VH1和VH2),应用Stata7.0统计学软件包对上述数据进行统计学分析。  结果    BF及VV出现的频率从T8到L5逐渐增大,BF和VV观察到的频率在性别间差异无统计学意义(P>0.05)。BFW、BFH、BFD从T8至L5随椎体增大相应增大。在不同椎体上BFD约为VD的1/3。VW1和VW2之间差异无统计学意义(P>0.05);VH1和VH2之间差异有统计学差异(P<0.05)。BF更接近椎体上终板。   结论    熟悉BF和VV在椎体内的分布有助于减少椎体成形术中骨水泥渗漏等并发症的发生。

Abstract

Objective To provide anatomic data for less complications of bone cement leakage in PKP and PVP. Methods A total of 40 health adults underwent multi-slice CT thin slice scans and three-dimensional reconstruction. In the horizontal and sagittal CT reconstruction images, display frequency of basivertebral foramen (BF) and vertebral vein (VV)of the branches of basivertebral venous system in vertebral bodies of T8~L5 were calculated. The sagittal diameter of vertebral body (VD), BF weight (BFW), BF depth (BFD), BF high (BFH) were measured. The distance between the BF and each side inthe horizontal and sagittal CT images were also measured. The measured parameters were analyzed statistically. Result Display frequency of BF and VV was gradually increasing from T8 to L5. Display frequencies of BF and VV in vertebral bodies were no significantly different between male and female (P>0.05). The distance from the BF to left or right side in the horizontal CT images were not significantly different (P>0.05). The distance from the BF to the cranial or caudal endplate in the saggital CT images were significantly different (P<0.05). The distance from the BF to the cranial endplate was shorter than to the caudal endplate. Conclusion For clinic operators, the knowledge of anatomic distribution of BF and VV in vertebral bodies helps to reduce the occurrence of bone cement leakage in PVP and PKP.

关键词

椎基静脉孔 / 椎体静脉 / 应用解剖 / 椎体成形术 / 术后并发症

Key words

Basivertebral foramen / Vertebral vein / Applied anatomy / Vertebroplasty / Postoperative complications

引用本文

导出引用
王素春,施建东,陆爱清,王志荣,张烽. 椎基静脉孔及椎体静脉解剖在椎体成形术中的意义[J]. 中国临床解剖学杂志. 2015, 33(6): 646-650 https://doi.org/10.13418/j.issn.1001-165x.2015.06.007
Anatomic distribution of basivertebral foramen and vertebral vein in vertebral bodies of T8~L5 and its clinical significance in PVP and PKP[J]. Chinese Journal of Clinical Anatomy. 2015, 33(6): 646-650 https://doi.org/10.13418/j.issn.1001-165x.2015.06.007

参考文献

[1]  郝定军, 贺宝荣, 许正伟, 等. 经皮椎体成形术改为开放手术的原因分析[J]. 中华骨科杂志,2012,32(10):951-956.
[2]  Phillips FM. Minimally invasive treatments of osteoporotic vertebral compression fracture[J]. Spine(Phila Pa 1976), 2003, 28(15 Suppl):S45-53.
[3]  Phillips FM, Todd Werzel F, Lieberman I, et al. An in vivo comparison of the potential for extravertebal cement leak after vertebroplasty and kyphoplasty[J]. Spine (Phila Pa 1976), 2002, 27(19):2173-2179..
[4]  Kaso G, Horvath Z, Szenohradszky K, et al. Comparision of CT characteristics of ertravertabral cement leakages after vertebroplasty performed by different navigation and injection techniques[J]. Acta Neurochir (Wien), 2008, 150(7):677-683.
[5] Crock HV, Yoshizawa H, Kame SK. Observations on the venous drainage of the human vertebral body[J]. J Bone Jiont Surg Br, 1973, 55(3):528-533.
[6]  Groen RJ, du Toit DF, Phillips FM, et al. Anatomical and pathological consideration in percutaneous vertebroplasty and kyphoplasty :a reappraisal of the vertebral venous system[J]. Spine(Phila Pa 1976), 2004, 29(13):1465-1471.
[7] Wenger M, Markwalder TM. Surgically controlled, transpedicular methyl methacrylate vertebroplasty with fluoroscopic guidance[J]. Acta Neurochir(Wien), 1999, 141(6):625-631.
[8]  贾连顺. 现代脊柱外科学[M]. 北京:人民军医出版社, 2007:29.
[9]  马春明, 鞠晓华, 杜晓东, 等. 胸椎椎基静脉孔的解剖学观测及测量[J].解剖学杂志,2013, 36(6):1087-1090.
[10]马春明, 鞠晓华, 王孝文, 等. 腰椎椎基静脉孔的解剖学观测及其临床意义[J].中国临床解剖学杂志,2014,32(4):405-408.
[11]王翀妍,单治,陈欢欢,等.椎基静脉孔与椎体内裂隙相通可能是后凸成形术骨水泥渗漏的危险因素[J].中华骨科杂志,2014, 34(4):373-379.
[12]赵兴凤, 赵凤东, 方向前, 等. 胸腰段椎体椎基静脉孔的CT影像学特征及其意义[J]. 中华骨科杂志,2012, 32(1):58-64.
[13]贺宝荣, 许正伟, 郝定军, 等. 骨水泥在骨质疏松性骨折椎体内分布状态与生物力学性能的关系[J]. 中华骨科杂志,2012, 32(8):768-773.
[14]Atlas SW, Regenbogen V, Rogers LF, et al. The radiographic characterization of burst fractures of the spine[J]. AJR Am J Roentgenol, 1986, 147(3):575-582.


Accesses

Citation

Detail

段落导航
相关文章

/