【摘要】 目的:研究腰椎左侧神经血管的解剖学参数,为腰椎腹腔镜左侧入路提供解剖学依据。方法:对16例经甲醛固定的成人防腐固定腰椎标本和2具新鲜标本进行观测。观察左侧生殖股神经的穿出方式、位置,并测量其相关数据;显露腰大肌内走行的生殖股神经并测量相关数据。结果:生殖股神经全部从腰大肌内穿出,以共干穿出者占68.75%(11/16),以两个单支穿出者占31.25%(5/16),其位置平均位于腰3上段。穿出点到腰大肌外侧缘、髂前上棘平面的距离分别为(18.20±6.24)mm、(109.24±20.53)mm;生殖股神经在腰2～3椎间盘水平有17侧经过,其到腰大肌前缘的距离为(19.25±6.69)mm、外侧缘的距离为(14.07±6.21)mm;在腰3～4椎间盘水平有3侧经过,其到腰大肌前缘的距离为(7.95±3.88)mm、外侧缘的距离为(17.80±9.18)mm。结论:为避免损伤生殖股神经,内镜下腰椎侧方经腰大肌至椎间盘入路的选择依次为腰4～5、腰2～3、腰3～4。更多还原

【Abstract】 Objective:To study the blood vessels and nerves on the left side of lumbar spine and to provide anatomical data for laparoscopic lateral transpsoas approach to the lumbar spine.Methods:Sixteen(12male and 4 female)adults fixed and two fresh male cadavers were observed and the course and location of the left genitofemoral nerve(GFN)were investigated.GFN located in the inside of the psoas major muscle(PM)was exposed and measured.Results:All GFNs were found to come out of PM,68.75%(11/16)of which had a common single trunk and 31.25%(5/16)with double trunk.The piercing points of GFN were found at the level of L3 in average.The distance from piercing points to the lateral border of PM and the plane joining bilateral anterior superior iliac spine were(18.20±6.24)mm and(109.24±20.53)mm respectively.There were 17 sides across L2/3 disc and the distance from GFN to the anterior and lateral border of PM were(19.25±6.69)mm and(14.07±6.21)mm respectively.There were 3 sides across L3/4 disc and the distance from GFN to the anterior and lateral border of PM on the level L3/4 were(7.95±3.88)mm and(17.80±9.18)mm respectively.Conclusion:For avoiding GFN injury,the feasibility of endoscopic lateral transpsoas approach to the lumbar spine below L2/3 disc level is L4/5>L2/3>L3/4.更多还原