Applied Anatomy Research of Lumbar Artery and Vein in Lumbar and Sacral Spinal Surgery_West China Medical Journal

Authors：

HUANG Kai , ZHANG Xiguang , YU Tao wei , et al.

Department of Orthopedics,the First Hospital of Nei jiang, Neijiang Sichuan 641200,China;

Corresponding author：

Keywords：

解剖; 腰骶椎手术; 腰动脉; 腰静脉

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目的:对腰动静脉的位置分布及变异进行描述和统计分析,以提高腰骶段脊柱手术手术的安全性和有效性.方法:对30具尸体标本进行解剖学研究,主要观察(1)腰动静脉的数量与缺失,各节段腰动静脉发出点位置的定性描述,(2)腰动静脉左右共干与上下共干的概率以及腰动静脉的其他变异。结果: 腰动脉的数量以及位置相对固定,有5对腰动脉的一共有5例,腰动脉发出点的位置也不是完全与腰椎对应。腰动脉左右共干的占9.6%,未见上下共干。动脉中仅有65.3%的动脉有静脉伴行。腰静脉的数量变异非常大,最少一侧仅有1支腰静脉,最多有5支,最常见的情况是3支,占36.7%。腰静脉的位置变异也较大,与椎体没有特别的规律。腰静脉的左右共干的概率要大于动脉,为38.5%,而上下共干也是腰静脉的独有的现象,总共有26支,占总数的12.5%。另外,腰静脉的其他变异多见。结论:当脊柱手术选择腹主动脉左侧入路或者腹主动脉下腔静脉之间入路时,腰动脉和腰静脉的解剖特点尤为重要。动脉的位置相对较恒定,而静脉则变异较大,缺失常见,左右共干,上下共干,静脉之间的大的交通支常见,与腰椎的对应性不如动脉,且其与动脉并非严格伴行,这些原因都造成了静脉容易损伤的原因,在手术中应该特别注意。

Citation： HUANG Kai,ZHANG Xiguang,YU Tao wei,et al.. Applied Anatomy Research of Lumbar Artery and Vein in Lumbar and Sacral Spinal Surgery. West China Medical Journal, 2009, 24(10): 2519-2521. doi: Copy

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1. WEBSTER B S, SNOOK S H. The cost of compensable upper extremity cumulative trauma disorders [J] J OccupMed, 1994.
2. TAIMELA S, KUJALA U M, SALM INEN J J, et al. The prevalence of low back pain among children and adolescents. Anationwide, cohort -based questionnaire survey in Finland [J].Spine, 1997, 22: 1132.
3. SALMINEN J J, ERKINTALO M, LAINEM, et al. Low back pain in the young: a prospective three year follow up study of subjects with and without low back pain[J]. Spine, 1995, 21: 2101.
4. LEHMANN T R, SPRATT K F, TOZZI J E, et al. Longterm followup of lower lumbar fusion patients. Spine 12:97, 1987.
5. Wesley W Parke, PhD, Joseph L Whalen MD, PHD, Robert E Van Demark MD, and Parviz Kambin MD The infraaortic arteries of the spine: their variability and clinical significance. [J] spine 1994,vol19 4-5.
6. Robert T. Vaney, MD, Frank M. Phillips, MD, F. Todd Wetzel, MD, and Marshall Brustein, MD Vascular Anatomy of the Lower Lumbar Spine an Endoscopic Perspective SPINE Volume 24, Number 21, pp 2183-2187.
7. THOMAS J, KLEEMAN, URI MICHAEL AHN, et al. Laparoscopic anterior lumbar interbody fusion at L4L5 An anatomic evaluation and approach classification[J]. Spine, 2002, 27 13901395.
8. ZEDEBLICK T A, DAVID S M, A prospective comparson of surgical approach for anterior L4-L5 fusion [J] Spine 2005.25:2682.2687.
9. 赵俊, 孙善全, 郭学利. 腹后区下腔静脉及其属支的解剖及意义. 重庆医科大学学报2003 年第28 卷第6 期 729-731.
10. Baniel Jack, Foster, Richard S. Donohue, John P. Surgical Anatomy of the Lumbar Vessels Implications for Retroperitoneal Surgery The Journal of Urology Volume 153(5), May 1995, pp 14221425.

West China Medical Journal

Applied Anatomy Research of Lumbar Artery and Vein in Lumbar and Sacral Spinal Surgery

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