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Analysis of anatomic morphometry of the pedicles and the safe zone for through-pedicle procedures in the thoracic and lumbar spine

机译:胸腰椎椎弓根椎弓根的解剖形态学分析和椎弓根穿刺术的安全区

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摘要

Posterior instrumentation through the pedicle is a common surgery. Understanding the morphometry of the pedicle and the anatomy of adjacent neural structures should help decrease the risk of postoperative complications. T1–L5 segments from 15 sets of human vertebrae were separated into individual vertebrae and the morphometric characteristics of the thoracic and lumbar spine and the safe zone of the pedicle were analyzed. T11–L5 segments from six human cadavers were dissected. Measurements were taken from the pedicle to the dura and nerve roots superiorly, inferiorly, medially, and laterally, and the transverse angles of the nerve roots were measured. Pedicles were widest in L5 and narrowest in T4 in the transverse plane, and widest in T11 or T12 and narrowest in T1 in the sagittal plane. In individual pedicle, the ranges of the safe zone width and height were 3.4–7.7 and 8.6–13.7 mm, respectively, in T1–T10; and 7.2–17.8 and 13.9–16.7 mm, respectively, in T11–L5. The transverse angle of the pedicle decreases progressively from T1 to T12, then increase from L1 to L5. In sagittal angle, the largest angle localized at T2 and the smallest at L5. The mean distances from pedicles to adjacent neural structures were greater superiorly and laterally than inferiorly and medially. The lateral distance between nerve root and the pedicle ranged from 2.4 to 9.6 mm in lumbar spine. This study provides potential safe zones for the application of through-pedicle procedures to help decrease the risk of postoperative complications.
机译:通过椎弓根的后路器械是常见的手术。了解椎弓根的形态和邻近神经结构的解剖结构应有助于降低术后并发症的风险。将15组人类椎骨的T1-L5节段分离成单个椎骨,并分析胸椎和腰椎的形态特征以及椎弓根的安全区。解剖了来自六个人类尸体的T11–L5段。从椎弓根至硬脑膜和神经根的上,下,内侧和外侧进行测量,并测量神经根的横向角度。椎弓根在矢状面上在L5中最宽,在T4中最窄,在T11或T12中最宽,在T1中最窄。在单个椎弓根中,T1-T10的安全区宽度和高度范围分别为3.4-7.7和8.6-13.7 mm;在T11–L5中分别为7.2–17.8和13.9–16.7 mm。椎弓根的横向角度从T1到T12逐渐减小,然后从L1到L5增大。在矢状角中,最大角位于T2,最小角位于L5。椎弓根到相邻神经结构的平均距离在上,外侧比在下,内侧要大。腰椎神经根与椎弓根之间的侧向距离为2.4至9.6mm。这项研究为应用椎弓根手术提供了潜在的安全区,以帮助降低术后并发症的风险。

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