腰椎后外侧部血供的应用解剖学研究及临床意义

目的：探讨腰椎后外侧入路摘除极外侧椎间盘突出手术中减少血管损伤的方法。方法：对30侧经动脉灌注乳胶的成人尸体标本进行局部解剖研究，解剖观测椎间孔前缘以后的腰动脉各级分支的起源、走行、外径及与出口神经的关系。结果：腰动脉从椎间孔前缘向外后内发出分支。在椎间孔外区，后支主干及其分支与出口腰神经前支的关系密切，血管呈“树叉”状从外侧将神经包绕。结论：紧贴腰椎峡部外缘，将后支血管及其分支推向外侧，是显露腰神经前支与极外侧型突出椎间盘的最安全、快捷的方法。

Applied anatomy study and clinical significance of the blood supply of posterior-lateral region of lumbar spine

Objective: To research an effective way to minimize bleeding in operating of patients with far-lateral lumbar disc herniation. Methods: The branches of lumbar artery were dissected backwards from the anterior edge of intervertebral foramen on 30 sides of adult cadaveric lumbar spine specimens injected with red dye. The origins, courses, diameters of the branches were measured as well as their relationships with the exiting nerves. Results: The lumbar arteries divided branches laterally, posteriorly and medially from the anterior boundary of intervertebral foramens. In the out space of the foramens, the posterior branches located laterally to the exiting nerve and formed an "arbor" around it. Conclusions: The optimum approach to far-lateral lumbar disc is via a lateral edge of pars interarticularis. After retracting the posterior branches laterally, the exiting nerve can be exposed safely and rapidly.