Chinese Journal of Clinical Anatomy >
The anatomical observation of L5~S1 intervertebral foramen associated with TESSYS' approach
Objective Provide objective anatomical basis for postolateral percutaneous L5~S1 transforaminal endoscopic discectomy. Method To the adjacent relationship among the needle, the iliac crest, the superior S1 articular process, the L5 efferent roots, the dura, and the vertebral vessels were observed and measured; various types of protrusion of puncture angle range in 10 adult spinal specimens(20 sides) were also measured when TESSYS was placed into the L5~S1 foramen. Results All data have not shown statistical difference by paired t test (P>0.05). There were L5 posterior medial nerve branches, descending branches of dorsal branches of L5 segmental arteries and veins going around the roots of S1 superior facet. The vertical distance from highest point of iliac crests to the midline of spine was (9.25±0.47) cm, the angle between highest point of iliac crests and leading edge of superior facets on the coronal plane was (11.10±1.17) °, the distance between L5 transverse processes and iliac crests on the coronal plane was (10.78±0.81) mm, central protrusion angle of the needle was (83.00±1.92) °, lateral protrusion angle of the needle was (32.15±1.63) °~( 62.60±1.70) °, extreme lateral protrusion angle of the needle was (11.75±1.16) °, the anchor points of superior facets to L5 exiting roots and the dura was (8.30±0.87) mm and (17.29±1.06) mm, respectively, inferior margin of L5 exiting roots to lower edge of foramen was (5.84±0.67) mm, the height of superior facets was (11.31±0.96) mm, the length of S1 superior facets was ( 17.41±0.98) mm. Conclusions The puncture and location of postolateral percutaneous L5~S1 transforaminal approach is complex than other lumbar segments, which requires that physicians have a solid knowledge of anatomy and excellent spatial visualization.
LI Song-Feng , ZHOU Liu , LI Ding , ZHANG Pei , LI Xi-Kai . The anatomical observation of L5~S1 intervertebral foramen associated with TESSYS' approach[J]. Chinese Journal of Clinical Anatomy, 2015 , 33(2) : 129 -133 . DOI: 10.13418/j.issn.1001-165x.2015
[1] Hoogland T, Schubert M, Miklitz B, et al. Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain: a prospective randomized study in 280 consecutive cases
[J]. Spine, 2006, 31(24):E890-E897.
[2] Hoogland T, van den Brekel-Dijkstra K, Schubert M, et al. Endoscopic transforaminal discectomy for recurrent lumbar disc herniation: a prospective, cohort evaluation of 262 consecutive cases
[J]. Spine, 2008, 33(9):973-978.
[3] Yeung AT, Tsou PM. Posterolateral endoscopic excision for lumbar disc herniation: Surgical technique, outcome, and complications in 307 consecutive cases
[J]. Spine, 2002, 27(7):722-731.
[4] 李振宙，吴闻文，侯树勋，等. 经皮腰椎间孔成形内窥镜下椎间盘切除术治疗腰椎间盘突出症的疗效观察
[J]. 中国脊柱脊髓杂志, 2008,18(10):752-756.
[5] 赵伟，李长青，周跃，等. 经皮椎间孔镜下TESSYS技术治疗腰椎间盘突出症
[J]. 中国矫形外科杂志, 2012, 20(13):1191-1195.
[6] 胡有谷，吕成昱，陈伯华. 腰椎间盘突出症的区域定位
[J]. 中华骨科杂志, 1998, 18(1):14-16.
[7] Schubert M, Hoogland T. Endoscopic transforaminal nucleotomy with foraminoplasty for lumbar disk herniation
[J]. Oper Orthop Traumatol,2005, 17(6):641-661.
[8] 刘宝平，何强，范先东，等. 经皮椎间孔镜治疗腰椎间盘突出症疗效观察
[J]. 人民军医, 2011, (6):472-473.
[9] 谢旭华，雷云坤，刘伟，等. 经皮椎间孔镜治疗腰椎间盘突出症临床疗效观察
[J]. 中国矫形外科杂志, 2012, 20(5):463-465.
[10]白一冰，徐岭，赵文亮，等. 经皮腰椎间孔镜手术的穿刺定位策略
[J]. 中国微创外科杂志, 2012, 12(6):540-543.
[11]Caglar S, Dolgun H, Ugur H C, et al. Extraforaminal lumbar arterial anatomy
[J]. Surg Neurol, 2004, 61(1):29-33, 33.
[12]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.
[13]孙兆忠，仲江波，房清敏，等. 下腰椎腰动脉的应用解剖学研究
[J]. 中国矫形外科杂志, 2010,18(17):1453-1456.
[14]潘曦东，刘文彪，张玉和，等. 腰神经后内侧支与骨纤维管的解剖学研究
[J]. 颈腰痛杂志,2000, 21(3):195-197.
/
| 〈 |
|
〉 |
