| 何文俊，伍卫新，王喆，邓峰，何云鹏，张小亮，张立，国雯琦，陈侃，张俊.基于M3D软件分析腰椎解剖特征的九宫针刀腰椎入路安全性研究[J].实用中西医结合临床,2022,22(7):13-16 |
| 基于M3D软件分析腰椎解剖特征的九宫针刀腰椎入路安全性研究 |
| Study on the Safety of Jiugong Needle Knife Lumbar Approach Using M3D Software for Analysis of Lumbar Spineanatomical Features |
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| DOI： |
| 中文关键词: 腰椎间盘突出症 九宫针刀 M3D软件 解剖 腰椎入路 安全性 |
| 英文关键词: Lumbar disc herniation Jiugong needle knife M3D software Anatomy Lumbar approach Safety |
| 基金项目:云南省卫生科技计划项目（编号：2018NS018） |
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| 中文摘要: |
| 目的：对九宫针刀在腰椎入路的相关解剖结构进行测量分析，探讨九宫针刀入路的安全性及安全操作空间。方法：选取2018年12月至2019年12月采用九宫针刀治疗的腰椎间盘突出症患者60例，以腰椎螺旋CT对患者腰椎进行扫描，采用M3D软件进行三维重建并测量L1~L5腰椎正中到小关节突的距离、关节突最高点到后正中线的距离、横突尖到后正中线的距离。对腰椎附近进针深度进行安全性分析，采用Pearson相关分析统计各参数与年龄、性别的相关性。结果：L1~L5腰椎正中到小关节突的距离、关节突最高点到后正中线的距离、横突尖到后正中线的距离各测量值与年龄、性别、身高及体质量无明显相关性（P＞0.05），相比于L1~L3腰椎正中到小关节突距离，L4、L5值更小（P＜0.05），但L4关节突最高点到后正中线的距离仅小于L1、L5（P＜0.05），L4、L5横突尖到后正中线的距离却大于L1、L2（P＜0.05），小于L3（P＜0.05）。结论：腰椎解剖分析证实九宫针刀腰椎入路具有安全的操作空间，但在腰椎间盘突出症患者L4、L5椎体层面操作时仍需小心谨慎。 |
| 英文摘要: |
| Objective: To measure and analyze the relevant anatomical structures of Jiugong needle knife in lumbar approach, and to explore the safety and safe operation space of Jiugong needle knife approach. Methods: 60 Patients with lumbar disc herniation treated in our hospital from December 2018 to December 2019 were selected. The lumbar spine of the patient was scanned by lumbar spiral CT, the three-dimensional reconstruction was performed by M3D software to measure the distance from the middle of L1~L5 lumbar vertebrae to facet process, the distance from the highest point of facet process to posterior midline, and the distance from the tip of transverse process to posterior midline. The safety of the needle insertion depth near the lumbar spine was analyzed, and the correlation between each parameter and age, gender was calculated by Pearson correlation analysis. Results: There was no significant correlation between the measured values of the distance from the middle of L1~L5 lumbar vertebrae to facet process, the distance from the highest point of facet process to posterior midline, and the distance from the tip of transverse process to posterior midline with age, gender, height and weight (P＞0.05). Compared with the distance from the middle of L1~L3 lumbar vertebrae to facet process, the values of L4 and L5 were smaller (P＜0.05). However, the distance fromthe highest point of facet process to posterior midline of L4 was smaller than those of L1 and L5. And the distance from the tip of L4 and L5 transverse process to the posterior midline were greater than that of L1 and L2(P＜0.05) and less than that of L3(P＜0.05). Conclusion: Lumbar anatomical analysis confirmed that Jiugong needle knife lumbar approach has a safe operation space, but it still needs to be cautious in L4 and L5 vertebral level operation in patients with lumbar disc herniation. |
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