在胸椎脊柱极端侧侧体间融合的CT解剖学研究
Zhenyu Zhong1, Moliang Xiong1, Liang Deng1
1Department of Orthopaedics, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China.
Medicine
|July 26, 2024
概括
极端侧侧体间融合 (XLIF) 不推用于T1-4由于脚阻塞. 在T4-11的左侧方法可能会损伤主要血管和食道,而T11/12是安全的. 从T5-12开始,右侧的方法更安全.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 人体解剖学 解剖学 解剖学
- 医疗成像医学成像
背景情况:
- 极端侧侧体间融合 (XLIF) 是治疗胸脊椎疾病的临床技术.
- 了解围绕胸脊的解剖关系对于手术安全至关重要.
研究的目的:
- 评估XLIF在胸脊椎的安全性和可行性.
- 根据解剖学变异和周围结构,识别与XLIF相关的潜在风险.
主要方法:
- 利用54名患者的CT图像分析胸脊椎解剖学.
- 应用摩罗方法将脊椎间空间划分为六个区域 (A,I,II,III,IV,P).
- 评估了肩,食道,胸前动脉和上腔静脉与手术走廊的距离.
主要成果:
- 骨阻塞影响T1-4区域 (II-III区域) 的80%以上的患者.
- 在T4-11的左侧接近带有伤害胸前动脉 (T4-9的80%),食道 (T4-9的3.7-24.1%) 和上腔静脉 (T5-9的3.7-18.5%) 的风险.
- 对于XLIF来说,T11/12段是安全的,对T5-12来说,右侧的方法是可行的,T4/5对上腔静脉构成风险.
结论:
- 对于T1-4脊椎,XLIF的使用是禁忌的,因为它会导致头巾入.
- 在T4-11的左侧XLIF需要仔细考虑血管和食道的近距离.
- 右侧XLIF通常对T5-12安全,对T4/5水平需要特别小心.
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