Abstract：
OBJECTIVE: To explore the relationship between the retroperitoneal vasculature and anterior surface of the lower spine, and to establish values for aiding in prediction of the pertinence of anterior approach at the L4-L5 and L5-S1 intervertebral discs.
METHODS: The study included 13 fresh human cadavers. After exploration of the abdominal cavity and removal of the visceral organs, the vasculature, and anterior spinal surface were revealed beneath the lower extension of the perirenal fascia. Morphometric measurements of the great vessels and the intervertebral discs were obtained. All measurements were analyzed and presented as mean and standard deviation. Differences in the values between sexes were assessed.
RESULTS: The anterior height of the L4-L5 and L5-S1 intervertebral disc was 6.8 ± 0.81 mm and 6.7 ± 0.99 mm, respectively. The widths of the aorta, inferior vena cava, right and left common iliac arteries, and right, and left common iliac veins were 16.4 ± 3.58, 20.6 ± 3.36, 11.5 ± 2.32, 11.5 ± 2.43, 14.7 ± 3.13, and 15.5 ± 3.27 mm, respectively. The mean aortic bifurcation angle was 45.5°. The aortic bifurcation was located above the lower endplate of the L4 vertebrae in 53.8% of the cadavers. The area of the interarterial and interiliac trigones was 14.6 ± 5.33 cm < sup > 2 < /sup > and 7.1 ± 4.35 cm2, respectively. No statistically significant differences were noted between the sexes.
CONCLUSIONS: An elaborate radiological examination of the vasculature should be performed prior to surgery to avoid unwanted vascular complications during the anterior approach. Knowing the area of the interarterial and interiliac triangles and the aortic bifurcation location could be aid in assessing the safe working zone.
METHODS: The study included 13 fresh human cadavers. After exploration of the abdominal cavity and removal of the visceral organs, the vasculature, and anterior spinal surface were revealed beneath the lower extension of the perirenal fascia. Morphometric measurements of the great vessels and the intervertebral discs were obtained. All measurements were analyzed and presented as mean and standard deviation. Differences in the values between sexes were assessed.
RESULTS: The anterior height of the L4-L5 and L5-S1 intervertebral disc was 6.8 ± 0.81 mm and 6.7 ± 0.99 mm, respectively. The widths of the aorta, inferior vena cava, right and left common iliac arteries, and right, and left common iliac veins were 16.4 ± 3.58, 20.6 ± 3.36, 11.5 ± 2.32, 11.5 ± 2.43, 14.7 ± 3.13, and 15.5 ± 3.27 mm, respectively. The mean aortic bifurcation angle was 45.5°. The aortic bifurcation was located above the lower endplate of the L4 vertebrae in 53.8% of the cadavers. The area of the interarterial and interiliac trigones was 14.6 ± 5.33 cm < sup > 2 < /sup > and 7.1 ± 4.35 cm2, respectively. No statistically significant differences were noted between the sexes.
CONCLUSIONS: An elaborate radiological examination of the vasculature should be performed prior to surgery to avoid unwanted vascular complications during the anterior approach. Knowing the area of the interarterial and interiliac triangles and the aortic bifurcation location could be aid in assessing the safe working zone.
摘要：
目的：下腰椎前路手术的一个重要并发症是血管损伤。动脉和静脉血管的大小和起源各不相同，这可能会限制手术区域并在特定情况下损害安全性。我们旨在探讨腹膜后脉管系统与下脊柱前表面之间的关系，并建立有助于预测L4-L5和L5-S1水平椎间盘前入路的相关性的值。
方法：该研究包括13具新鲜的人类尸体。在探查腹腔并切除内脏器官后，脉管系统,和脊柱前表面显示在肾周筋膜下部延伸下方。获得了大血管和椎间盘的形态测量。分析所有测量值并表示为平均值和标准偏差。评估了两性之间的数值差异。
结果：L4-L5和L5-S1椎间盘的前高度分别为6.8±0.81mm和6.7±0.99mm，分别。主动脉的宽度,下腔静脉,左右髂总动脉,对，左髂总静脉分别为16.4±3.58,20.6±3.36,11.5±2.32,11.5±2.43,14.7±3.13,15.5±3.27mm,分别。平均主动脉分叉角度为45.5°。在53.8％的尸体中，主动脉分叉位于L4椎骨的下终板上方。动脉间和髂间三角区面积分别为14.6±5.33cm2和7.1±4.35cm2。性别之间没有统计学上的显着差异。
结论：手术前应进行详细的血管放射学检查，以避免前路手术中不必要的血管并发症。了解动脉间和髂间三角形的面积以及主动脉分叉位置可以帮助评估安全工作区。
方法：该研究包括13具新鲜的人类尸体。在探查腹腔并切除内脏器官后，脉管系统,和脊柱前表面显示在肾周筋膜下部延伸下方。获得了大血管和椎间盘的形态测量。分析所有测量值并表示为平均值和标准偏差。评估了两性之间的数值差异。
结果：L4-L5和L5-S1椎间盘的前高度分别为6.8±0.81mm和6.7±0.99mm，分别。主动脉的宽度,下腔静脉,左右髂总动脉,对，左髂总静脉分别为16.4±3.58,20.6±3.36,11.5±2.32,11.5±2.43,14.7±3.13,15.5±3.27mm,分别。平均主动脉分叉角度为45.5°。在53.8％的尸体中，主动脉分叉位于L4椎骨的下终板上方。动脉间和髂间三角区面积分别为14.6±5.33cm2和7.1±4.35cm2。性别之间没有统计学上的显着差异。
结论：手术前应进行详细的血管放射学检查，以避免前路手术中不必要的血管并发症。了解动脉间和髂间三角形的面积以及主动脉分叉位置可以帮助评估安全工作区。
