腹部内部内容运动 倾斜对侧位 侧腰间体融合 (LLIF)
Cristiano M Menezes1,2, Luciene M Andrade3, Gabriel C Lacerda2
1Department of Locomotor System, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.
Spine
|January 4, 2024
概括
腰部内体融合的倾斜位置显著改变了腹部解剖学,导致后肠迁移. 这创造了一个更长的外科手术走廊和一个更小的工作窗口,与横向部位置相比,潜在地增加了内脏风险.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 解剖成像 解剖成像 解剖成像
- 手术定位手术定位手术定位
背景情况:
- 在横向部 (LD) 位置的侧面横向体和腰椎体融合 (LLIF) 已被解剖学验证.
- 躺卧的LLIF正在成为一种替代性手术方法.
- 了解位置之间的解剖学变化对于程序安全至关重要,特别是在内脏风险方面.
研究的目的:
- 为了确定腹部内容是否在横侧 (LD) 和倾斜位置之间发生变化.
- 为了比较内脏结构与LLIF走廊在LD与倾斜位置的解剖关系.
主要方法:
- 涉及健康志愿者的前性解剖成像研究.
- 腰部神经区域的磁共振成像 (MRI) 在LD (部曲) 和倾斜 (腿伸展) 两种位置.
- 在轴性MRI切片上对L4-5磁盘空间的解剖测量.
主要成果:
- 从皮肤到横盘表面的距离在倾斜的位置 (134.9毫米) 比LD (118.7毫米) 更大.
- 结肠在斜卧的位置上向后移动,显著减少了与后盘的距离 (20.3毫米 vs. 41.1毫米在LD).
- 100%的受试者在倾斜的位置相对于LD位置显示后肠部迁移.
结论:
- 显著的解剖学变化发生在LD和LLIF倾斜位置之间的内脏结构定位中.
- 倾斜的位置提供了一个更长的手术走廊,但一个较小的,结肠侵占工作窗口与LD相比.
- 外科医生必须考虑在倾斜位置执行LLIF时内脏损伤的增加潜力.
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