[1]范亚朋,李道通.腰椎间盘突出症相关侵入类治疗体位下后侧安全入路临床研究[J].陕西医学杂志,2019,(3):348-351.
　FAN Yapeng,LI Daotong..Clinical study on the posterior safety approachfor invasive treatment of patients with lumbar disc herniation[J].,2019,(3):348-351.
点击复制

腰椎间盘突出症相关侵入类治疗体位下后侧安全入路临床研究
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年3期
页码:
348-351
栏目:
基础研究
出版日期:
2019-03-05

文章信息/Info

Title:
Clinical study on the posterior safety approachfor invasive treatment of patients with lumbar disc herniation
文章编号:
DOI:10.3969/j.issn.10007377.2019.03.017
作者:
范亚朋; 李道通
1.河南省洛阳正骨医院（河南省骨科医院）东花坛院区（洛阳 471200）
Author(s):
FAN Yapeng; LI Daotong.
Luo yang Zheng gu Hospital in Henan Province(Henan Provincial Orthopedic Hospital)(Luoyang 471200)
关键词:
腰椎间盘突出症; 侵入类治疗; 后侧安全入路; MRI
Keywords:
Key words Lumbar intervertebral disc protrusion; Invasive treatment; Posterior safe approach; MRI
分类号:
R681.5
文献标志码:
A
摘要:
摘 要 目的：探讨腰椎间盘突出症相关侵入类治疗体位（俯卧位）下的后侧安全入路。方法：选择成年腰椎间盘突出症患者22例，用3.0T MRI对其腰椎（L1S1）进行扫描，分别测量双侧上位腰椎下关节突外缘和下位腰椎上关节突外缘至后正中线的水平间距、双侧腰椎关节突关节后缘至腰背侧皮肤的最近距离，统计其差异。结果：侵入类治疗体表入路安全区间为距离后正中线：L12为10.83～17.5 mm、L23为13.03～19.17 mm、L34为15.72～21.20 mm、L45为19.47～25.55 mm、L5S1为24.69～29.04 mm；侵入类治疗体内活动安全区间:L12为7.03～7.93 mm、L23为6.80～8.10 mm、L34为6.57～7.66 mm、L45为7.63～8.63 mm、L5S1为6.13～7.27 mm，侵入类治疗的体内进针深度安全区间:L12为37.19～39.85 mm、L23为38.64～41.45 mm、L34为40.23～43.60 mm、L45为43.07～46.57 mm、L5S1为45.24～49.00mm。结论：侵入类治疗的进针点、体内活动范围、进针深度，以平行矢状面和垂直冠状面进针较为安全，且应结合腰椎MRI，确保治疗的个体性、精确性、安全性。
Abstract:
Abstract Objective:To investigate the posterior safety approach in patients with lumbar intervertebral disc protrusion associated with invasive treatment (prone position).Methods: Twentytwo adult volunteers were selected and their lumbar vertebrae (L1S1) were scanned with 3.0T MRI. The horizontal distance between the Upper lumbar subtotal articular process and the lower lumbar superior articular process to the posterior median line was measured. The closest distance from the posterior edge of the lateral lumbar facet joint to the skin on the lower back was counted. And count the differences.Results:The safety interval of the invasive treatment surface is the distance from the midline: L12:10.8317.5mm,L23:13.0319.17mm,L34:15.7221.20mm,L45:19.4725.55mm,L5S1:24.6929.04mm. Invasive treatment of in vivo activity safety interval: L12:7.037.93mm,L23:6.808.10 mm,L34:6.577.66mm,L45:7.638.63mm,L5S1:6.137.27mm. Needle depth safety interval for invasivetreatment:L12:37.1939.85mm,L23:38.6441.45mm,L34:40.2343.60mm,L45:43.0746.57mm,L5S1:45.2449.00mm.Conclusion: The needle insertion point, the range of motion in the body, and the depth of the needle in the invasive treatment are safer in the parallel sagittal plane and the vertical coronal plane, and should be combined with lumbar MRI to ensure the individuality, accuracy and safety of the treatment.

参考文献/References:

[1] 王仁群,任玉炳,卢 安,等.理筋正骨手法牵引配合中药治疗腰椎间盘突出症的的临床研究[J].陕西中医,2016,37(2):240242.
[2] 潘琪豹.中西医结合保守治疗腰椎间盘突出症的疗效观察究[J]. 临床合理用药杂志,2017,11:3536. \[3\] 闫振界，闫 梅，王换新. 小针刀治疗急性腰椎间盘突出症的效果临床观[J].黑龙江中医药, 2018,61(2):7980. \[4\] 张立勇,叶勇,邵湘宁，等.小针刀治疗腰椎间盘突出症的 Meta分析[J].针灸临床杂志,2014,(2):4953. \[5\] 王振涛,韩玉龙,李彦平.椎旁神经阻滞复合臭氧治疗腰椎间盘突出的疗效研究[J].临床和实验医学杂志,2015,(12):10371039.
[6] 王金晨.椎旁神经阻滞复合臭氧治疗腰椎间盘突出效果观察[J].河南外科学杂志,2017,23(4):116117.
[7] 宋学岐.臭氧治疗腰椎间盘突出合并椎管狭窄症100例[J].中国组织工程研究,2014,(B05):7374.
[8] 杨 越.小针刀治疗腰椎间盘突出症的应用及可行性研究[J].临床医药文献杂志（电子版）, 2017,26：50115013.
[9] 黄 叶,杨 拯,田 芸，等.小针刀治疗腰椎间盘突出症的系统评价[J].时珍国医国药,2010,21(9):24202422. 
[10] 赵守宇,白伟东,于培俊，等.针刺联合小针刀治疗腰椎间盘突出症的疗效观察及对患者生活质量的影响分析[J].中国医药科学,2016,6(6):183185.
[11] 王 恺,罗 军,朱怡文.钩针刀联合定点旋转手法治疗包容性腰椎间盘突出症[J].实用中西医结合临床,2017,17(9):2628.
[12] 王鸿明.减压松解治疗腰椎间盘突出症202例临床疗效观察[J].医学信息,2012,25(9):199200.
[13] 杨石照,李浩旭,陈 敏,等.腰椎参数解剖学测定40例[J].陕西医学杂志,2006,35(8):10541055.
[14] 赖必华,徐宏光.腰椎关节突关节不对称的病因学意义[J].医学综述,2007,13(8):614616.
[15] 马 辉,张 燕,吕新光.术前磁共振影像对腰椎间盘突出症术后复发的评估价值[J].陕西医学杂志,2016,45(12):16411642,1643.

相似文献/References:

[1]郭 强,康 超△,高晓猛,等.双极调压脉冲射频联合小剂量胶原酶治疗腰椎间盘突出症29例临床研究*[J].陕西医学杂志,2019,(12):1627.
　GUO Qiang,KANG Chao,GAO Xiaomeng,et al.The clinical effects of the bipolar needle manual pressure regulator pulsed radiofrequency combined small dose of collagenase on lumbar intervertebral disc herniation[J].,2019,(3):1627.
[2]李 杰,张小军,刘 凯△.两种术式治疗腰椎间盘突出症近远期疗效对比研究*[J].陕西医学杂志,2019,(12):1646.
　LI Jie,ZHANG Xiaojun,LIU Kai..Shortterm and longterm curative effect of two surgical treatments for lumbar disc herniation[J].,2019,(3):1646.
[3]常 龙,张 晨,张佳林,等.经皮椎间孔镜椎间盘切除术与开窗减压髓核摘除术治疗单节段腰椎间盘突出症临床效果对比研究[J].陕西医学杂志,2021,50(3):289.[doi:DOI:10.3969/j.issn.1000-7377.2021.03.008]
　CHANG Long,ZHANG Chen,ZHANG Jialin,et al.Comparative study on the clinical effect of PTED and ODD in treatment of single-segment lumbar disc herniation[J].,2021,50(3):289.[doi:DOI:10.3969/j.issn.1000-7377.2021.03.008]
[4]方锋助,牒 军,李展奇,等.经皮椎间孔镜椎间盘切除术治疗腰椎间盘突出症复发情况及影响因素分析[J].陕西医学杂志,2021,50(3):297.[doi:DOI:10.3969/j.issn.1000-7377.2021.03.010]
[5]李 伟,邱龙顺,黄 新,等.经皮椎间孔镜椎间盘切除术与经椎间孔椎体间融合术治疗腰椎间盘突出合并椎管狭窄症疗效对比研究[J].陕西医学杂志,2021,50(3):319.[doi:DOI:10.3969/j.issn.1000-7377.2021.03.016]
　LI Wei,QIU Longshun,HUANG Xin,et al.Comparative study on the efficacy of percutaneous transforaminal endoscopic discectomy and transforaminal lumbar interbody fusion in treatment of lumbar disc herniation combined with spinal stenosis[J].,2021,50(3):319.[doi:DOI:10.3969/j.issn.1000-7377.2021.03.016]
[6]葛郁龙,康银辉.术前坐骨神经传导速度与腰椎间盘突出症经皮椎间孔镜下椎间盘切除治疗效果相关性研究[J].陕西医学杂志,2022,51(10):1253.[doi:DOI:10.3969/j.issn.1000-7377.2022.10.018]
[7]邵海龙,穆佐洲.机体炎症水平和氧化应激水平与腰椎间盘突出症椎间孔镜术后残留疼痛相关性研究[J].陕西医学杂志,2022,51(10):1274.[doi:DOI:10.3969/j.issn.1000-7377.2022.10.024]
　SHAO Hailong,MU Zuozhou.Correlation between inflammation level,oxidative stress level and residual pain after transforaminal endoscopic surgery for lumbar disc herniation[J].,2022,51(3):1274.[doi:DOI:10.3969/j.issn.1000-7377.2022.10.024]
[8]高海聪,张永锋,张小军,等.自制椎弓根定位器辅助下关节突外侧入路脊柱内镜技术临床应用研究[J].陕西医学杂志,2023,52(8):1019.[doi:DOI:10.3969/j.issn.1000-7377.2023.08.017]

更新日期/Last Update: 2019-03-15