L_4～L_5和L_5～S_1旁椎间孔注射穿刺入路的应用解剖研究

目的行L4～L5和L5～S1节段旁椎间孔注射穿刺入路确定安全范围。方法以30例X线胶片的缩放比例作为参照依据,12侧标本模拟试验穿刺入路解剖。结果后正中线旁开2.0～2.5 cm处穿刺入路,在L4～L5椎间孔下半部分,即L4神经根下方(10.6±1.4)mm和L5神经根上缘至相应椎弓根下切迹间距(1.9±0.7)mm,是行椎间孔外口注射的安全区。结论标本后正中线旁开2.0～2.5 cm的范围穿刺与临床采用X光胶片推算出体表实际距离基本一致。由此旁椎间孔穿刺入路能避开重要的血管神经,L4～L5椎间孔直达安全三角工作区;L5～S1安全三角区范围消失,L5神经根上缘至相应椎弓根下切迹间距为注射区。

Applied anatomy of puncture approach about foramen in tervertebrale injection beside the lower lumbar vertebrae

Objective To determine the safe range of puncture approach about foramen intervertebrale injection beside the lower vertebrae lumbales.Methods To simulate puncture approach about foramen intervertebrale injection beside the lower vertebrae lumbales through anatomy of 12 sides of cadaver specimens in a reference for the scaling of the 30 cases of X-ray film about it.Results The puncture approach about it in the range of 2～2.5 cm of the lateral of the posterior median line that is the range(11.3±1.6)mm from the lower half of the foramen intervertebrale injection beside the fourth-fifth vertebrae lumbales and the nerve roots of the fifth vertebrae lumbale to the relevant root of arch of vertebra inferior incisure is safe.Conclusion The real distance(1.6±2.7)cm according to the projection with the X-ray film about it Is consistent with the range of puncture approach in the cadaver specimens,and it is the safe range.