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报告下腰段经皮椎间盘穿刺的尸体解剖实验。结果表明L_3、4、L4、5进针点选在距棘突8~14cm,取矢状面35°~45°刺入椎间盘成功率较高。针道经背阔肌,骶棘肌,腰方肌和腰大肌进入椎间盘后外侧,可避免损伤大血管,较安全。针末进椎管,不遗留神经根粘连,硬脊膜纤维化,更不损伤神经。L5、S1取L4、5平面距棘突6~8cm,矢状面45°~55°,冠状面40°~55°可刺入椎间盘,但难度较大。对神经根、小关节及下一椎体上线在解剖上形成的三角进行了描述。实验证明,经皮腰椎间盘穿刺应用于临床,只要严格选择适应症,精确定位,正确地运用操作技术,有可能取得理想效果。
Report on the autopsy of lower lumbar percutaneous disc. The results showed that the success rate of insertion of L_3,4, L4,5 needle from the spinous process 8 ~ 14cm, sagittal plane 35 ° ~ 45 ° into the intervertebral disc. Needle Road latissimus dorsi, sacral spine muscle, psoas muscle and psoas into the posterolateral disc, to avoid damage to the large blood vessels, safer. Needle into the spinal canal, leaving no nerve root adhesions, dura fibrosis, but also does not damage the nerves. L5, S1 take L4,5 plane from spinous process 6 ~ 8cm, sagittal 45 ° ~ 55 °, coronal 40 ° ~ 55 ° can penetrate the intervertebral disc, but more difficult. Anatomical triangulation of nerve roots, facet joints and the next vertebral line was described. Experiments show that percutaneous lumbar puncture applied to clinical, as long as the strict selection of indications, precise positioning, the proper use of operating techniques, it is possible to achieve the desired effect.