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目的:观察左腰静脉、左腰升静脉及骶正中静脉的解剖学变异情况,为前侧腹膜外入路人工腰椎间盘置换术提供该区域的解剖学依据,以减少术中血管副损伤。方法:解剖40例成人尸体标本L3椎体以下左侧以及骶前的下腔静脉属支,重点观察左侧腰静脉、左腰升静脉及骶正中静脉的解剖学特点。结果:左侧L3、L4、L5静脉存在于85%、97.5%和67.5%的标本中,位置与外径相对恒定,内侧汇入下腔静脉或左髂总静脉,外侧与左腰升静脉相交通;左腰升静脉存在于47.5%的标本中,位置较恒定,但起点、外径以及形态均有较大的变异;所有标本中均可找到骶正中静脉,其外径变异不大,但是数目及止点均有明显变异,并且可不伴行骶正中动脉。结论:下腔静脉于下腰椎水平左侧及骶前的属支变异多样,从左侧腹膜外手术入路暴露下腰椎间盘时,需要术前了解左腰静脉、左腰升静脉及骶正中静脉的情况并在术中做相应处理。
OBJECTIVE: To observe the anatomical changes of left lumbar vein, left lumbar ascending vein and sacral median vein, and to provide an anatomic basis for anterior lumbar intervertebral disc artificial lumbar disc replacement in this area to reduce intraoperative blood vessel injury. Methods: Anatomy of the left inferior vena cava below the L3 vertebral body of 40 adult cadavers and the anterior sacral inferior vena cava were dissected. The anatomic features of the left lumbar vein, the left lumbar ascending vein and the median sacral veins were observed. Results: The left L3, L4 and L5 veins were present in 85%, 97.5% and 67.5% of the specimens with a relatively constant position and external diameter. The vena cava branches into the inferior vena cava or left common iliac vein, while the lateral and left lumbar ascending vein Traffic; left lumbar ascending vein in 47.5% of the specimens, the location is relatively constant, but the starting point, diameter and morphology have greater variation; all specimens can be found in the median sacral veins, the diameter of small variations, but The number and stop point have significant variation, and may not be accompanied by the median sacral artery. CONCLUSIONS: The inferior vena cava has many branches in the left lumbar spine and presacral. When the left lumbar intervertebral disc is exposed through the left extraperitoneal approach, it is necessary to know the left lumbar vein, left lumbar ascending vein and sacral median vein preoperatively Situation and in the surgery to do the appropriate treatment.