Objective To measure and analyze the anatomical data of magnetic resonance neurography (MRN) of lower lumbar Kambin triangle working area in normal adults, so as to provide reference for the selection and safety evaluation of minimally invasive surgery of lower lumbar spine. Methods Twenty healthy adult volunteers (male: 10, female: 10) were performed magnetic resonance imaging scan at L4~S1 segment with 3.0 T MRN. The neuroimaging was performed by OsiriX software. The following data were measured: the distance between ganglion and superior pedicle (A), the distance between ganglion and lower pedicle (B), and the angle between nerve root and dural sac (α), area of Kambin triangle (S). Finally, the measured data were statistically analyzed. Results From L4 to S1 segment, the distance between ipsilateral ganglion and superior pedicle decreased gradually (P<0.05). But there was no statistical difference between ipsilateral ganglion and lower pedicle (P>0.05). From L4 to S1, the angle between ipsilateral outlet nerve root and dural sac gradually decreased, the difference was statistically significant (P<0.05). From L4 to S1, the area of Kambin triangle increased gradually (P<0.05). In addition, there was no statistical difference between the left and right sides of the same segment (P>0.05). Conclusions MRN technology can clearly and accurately visualize the anatomical relationship of the Kambin triangle structures of the lower lumbar spine, which is helpful to measure the relevant anatomical data and can guide the selection of minimally invasive surgical methods and the evaluation of surgical safety.
Key words
Kambin triangle /
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Magnetic resonance neuroimaging /
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Anatomical structure /
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Lumbar minimally invasive surgery
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References
[1] 袁仕国, 李义凯, 王华军, 等. 腰椎间孔侵入性操作的应用解剖[J]. 中国临床解剖学杂志, 2010, 28(2): 127-130. DOI: 10.7666/d.y1997338.
[2] 王一丹, 许阳阳, 苏宝科, 等. 经皮椎间孔镜技术治疗腰椎疾病的研究进展[J]. 中国临床解剖学杂志, 2020, 38(4): 488-491. DOI: 10.13418/j.issn. 1001-165x.2020.04.024.
[3] 马国骏, 张建军, 赵秋枫, 等. 磁共振3D神经成像对腰骶丛显示的对比研究[J]. 医学影像学杂志, 2016, 26(7): 1157-1159. CNKI: SUN:XYXZ.0.2016-07-002.
[4] Khadilkar S, Deshmukh ND, Shah NH, et al. Optimizing investigations for evaluation of enlargements of the roots, plexuses and nerves: a study of 133 patients[J]. Ann Indian Acad Neurol, 2020, 23(5): 666-673. DOI: 10.4103/aian.AIAN_504_19.
[5] 王浩, 赵星丞, 陈秋, 等. 经皮椎间孔镜下椎间盘切除治疗腰椎间盘突出症的效果[J]. 临床骨科杂志, 2020, 23(4): 506-509. DOI: 10.15887/j.cnki.13-1389/r.2020.12.071.
[6] Fanous AA, Tumialán LM, Wang MY. Kambin's triangle: definition and new classification schema[J]. J Neurosurg Spine, 2019, 32: 390-398. DOI: 10.3171/2019.8.SPINE181475.
[7] König A, Joseph F, van Rensburg JC, et al. Kambin's triangle and the position of the dorsal nerve root in the lumbar neural foramen[J]. Clin Anat, 2020, 33(8): 1204-1213. DOI: 10.1002/ca.23565.
[8] 张明, 郑祖根. 腰椎神经根管狭窄神经根受压的形态学变化及其临床意义[J]. 中国临床解剖学杂志, 2002, 20(2): 109-111. DOI: 10.3969/j.issn.1001-165X.2002.02.010.
[9] Attar A, Ugur HC, Uz A, et a1. Lumbar pedicle: surgical anatomic evaluation and relationships[J]. Eur Spine, 2001, 10(1): 10-15. DOI: 10.1007/s005860000198.
[10] 朱爱国, 陈云, 张烽, 等. 腰骶丛三角工作区的应用解剖及临床意义[J]. 中国组织工程研究, 2016, 20(53): 7946-7951. DOI: 10.3969/j.issn.2095-4344.2016.53.006.
[11] Xie PG, Feng F, Chen ZH, et al. Percutaneous transforaminal full endoscopic decompression for the treatment of lumbar spinal stenosis[J]. BMC Musculoskelet Disord, 2020, 21(1): 546. DOI: 10.1186/s12891-020-03566-x.
[12] Howe FA, Filler AG, Bell BA, et al. Magnetic resonance neurography[J]. Magn Reson Med, 1992,28(2): 328-338. DOI: 10.1002/mrm. 1910280215.
[13] Onder H, Goksungur G. The utility of neuroimaging parameters in discriminating patients of normal-pressure hydrocephalus with positive cerebrospinalfluid tap test response from healthy controls[J]. Ann Indian Acad Neurol, 2020, 23(5): 625-631. DOI: 10.4103/aian.AIAN_583_19.
[14] Hiscox LV, Schwarb H, McGarry MDJ, et al. Aging brain mechanics: progress and promise of magnetic resonance elastography[J]. Neuroimage, 2021,232:117889. DOI: 10.1016/j.neuroimage. 2021. 117889.
[15] 王敏, 赵庆豪, 苏志海, 等. 基于CT/MRI融合建立的Kambin三角三维模型与标本测量的对比研究[J]. 中国脊柱脊髓杂志, 2019, 29(1): 67-73. DOI: 10.3969/j.issn.1004-406X.2019.01.11.
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