ĐẶC ĐIỂM GIẢI PHẪU ĐỘNG MẠCH THẮT LƯNG ỨNG DỤNG TRONG PHẪU THUẬT HÀN XƯƠNG LIÊN THÂN ĐỐT CỘT SỐNG LỐI BÊN

Abstract

Objective: To use computed tomography angiography to evaluate the regional anatomy of the lumbar segmental arteries associated with the surgical field in lateral interbody fusion. Methods: Computed tomography angiography 64 slides images from 62 patients were reviewed. In the sagittal plane, distances from the lumbar segmental arteries to the upper and inferior edges of the vertebral body were measured in the anterior quarter of the anterior and median lines of the intervertebral disc. Lumbar segmental arteries were classified as types I-IV based on the zone in which they passed through the vertebral body. Results: All lumbar arteries originate from the abdominal aorta. The incidence of lumbar arteries is high at L1 to L4 but only 16.1% at L5. The distance from the lumbar artery to the superior border compared to the inferior border of the vertebrae is higher at L1 and L2 and lower at L4 and L5. Type 1 is not found at regions II and III of the vertebrae from L1 to L5. Type IV in regions II and III is found only in 13/58 patients with L1, 18/62 patients with L2, 17/62 patients with L3, 23/55 patients with L4 and 2/10 patients with L5. Conclusion: The safe zone that limits injury to the lumbar Segmental artery during lateral interbody fusion surgery during the placement of the cage is zone II and III. The fixation pin should be placed near the superior vertebral border at L1-L2 -L3 and the inferior vertebral border at L4 and L5.