Abstract:
This prospective anatomical study aimed to establish an ultrasound-guided technique to the quadratus lumborum (QL) plane in sheep cadavers. Thirteen cadavers, weighing less than 117 kg, were included. In phase 1, one cadaver underwent dissection and two cadavers underwent 3D computed tomographic reconstruction for anatomical evaluation of the thoracolumbar region. In phase 2, two cadavers were used to compare two ultrasound techniques to the QL plane: lateral to the QL muscle with a transversal approach (LQL) and transmuscular between QL and psoas muscles with a longitudinal approach (TQL). For LQL, the reference was the first lumbar transverse process, whereas for TQL, it was the intertransverse region between the first and second lumbar vertebrae. The needle was advanced in-plane towards the specific target for each technique and a total of four injections were performed using 0.4 ml kg-1 of a dye-lidocaine solution. In phase 3, 10 cadavers received bilateral LQL injections (n = 20). All cadavers were then dissected to evaluate spread of dye. In phase 2, following LQL injections, no dye was observed in undesired locations; however, the dye was noted in the retroperitoneal space (1/2) after TQL injections. In phase 3, the 13th thoracic, first, second, third lumbar nerves, and sympathetic trunk segments were stained in 80%, 95%, 100%, 45% and 35% of the injections, respectively. In conclusion, the LQL technique was feasible, allowing staining of the spinal nerves innervating the cranial abdomen in sheep cadavers. Further studies in live animals are warranted.
摘要:
这项前瞻性解剖学研究旨在建立一种超声引导技术,用于绵羊尸体的腰方肌(QL)平面。13具尸体,重量小于117公斤,包括在内。在第1阶段,对一具尸体进行了解剖,对两具尸体进行了3D计算机断层扫描重建,以对胸腰椎区域进行解剖评估。在第2阶段,使用两具尸体将两种超声技术与QL平面进行比较:采用横向方法(LQL)的QL肌肉外侧以及采用纵向方法(TQL)的QL和腰大肌之间的跨肌肉。对于LQL,参考是第一个腰椎横突,而对于TQL来说,它是第一和第二腰椎之间的横向区域。对于每种技术,将针在平面内朝特定目标前进,并使用0.4mlkg-1的染料-利多卡因溶液进行总共四次注射。在第3阶段,10具尸体接受了双侧LQL注射(n=20)。然后解剖所有尸体以评估染料的扩散。在第二阶段,在LQL注入之后,在不希望的位置没有观察到染料;然而,TQL注射后,在腹膜后间隙(1/2)观察到染料.在第三阶段,第13胸部,首先,第二,第三腰神经,80%的交感神经干段被染色,95%,100%,45%和35%的注射,分别。总之,LQL技术是可行的,允许染色支配绵羊尸体颅腹部的脊神经。有必要对活体动物进行进一步的研究。