Neuroimaging study of interlaminar percutaneous endoscopic lumbar discectomy
10.3760/cma.j.issn.1671-8925.2019.08.010
- VernacularTitle:经椎板间隙入路完全内镜下腰椎间盘髓核摘除术的神经影像学测量
- Author:
Yanhong LIU
1
;
Bo ZHONG
;
Shengtao WANG
;
Congxian YANG
;
Siyan ZHANG
;
Sanliang LI
;
Huayong CHEN
Author Information
1. 潍坊市益都中心医院麻醉科 262500
- Keywords:
Magnetic resonance neurography;
Interlaminar approach;
Percutaneous endoscopic lumbar discectomy
- From:
Chinese Journal of Neuromedicine
2019;18(8):818-823
- CountryChina
- Language:Chinese
-
Abstract:
Objective To utilize the magnetic resonance neurography (MRN) as a feasible tool for measuring the anatomical parameters of lumbar spinal nerves, and further to evaluate the neuro-safety of interlaminar percutaneous endoscopic lumbar discectomy.Methods Thirty healthy adult volunteers without significant history of low back pain or lumbar deformity were selected in our hospital from September 2016 to December 2016. All subjects accepted MRN. The nerve roots of L2-S1 were measured at the starting point of dural sac, and the angles between nerve roots and dural sac were measured. The distances between L2-L5 nerve roots and the edge of ipsilateral dural sac were measured and analyzed statistically.Results All MRN showed a gradual increase in the origin of the nerve roots from L2 to S1. The origin of the root was found to be below the corresponding disc for the L2 to L4 roots. There were 70％ of the L5 roots originated below the L4/5 disc, 26.7％ at the L4/5 disc, and 3.3％ above the L4/5 disc; about 70％ of the S1 roots originated above the L5/S1 disc. There were no statistically significant differences in the angles between dural sac and both left and right nerve roots (P>0.05). The angels between the nerve root and the dural sac from L5 and S1 was smaller than those from L2, L3, and L4 (P<0.05); that from S1 was significantly smaller than that from L5 (P<0.05). The distance of the nerve root and the ipsilateral dural sac was significantly increased in each side from L2 to L5 (P<0.05). There was no statistically significant difference in the distances between the left and right nerve roots and the edge of the ipsilateral dural sac in the same segment (P>0.05).Conclusion MRN is a feasible tool to measure the anatomical parameters of the lumbar spinal nerve, and there is a safe neurological area of the percutaneous endoscopic lumbar discectomy through the interlaminar approach.
