The use of computed tomography angiography to define the prevertebral vascular anatomy prior to anterior lumbar procedures
The use of computed tomography angiography to define the prevertebral vascular anatomy prior to anterior lumbar procedures
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DOI：
10.1097/01.brs.0000250991.02387.84
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发表时间：
2007-01-01
期刊：
影响因子：
3
通讯作者：
Ponce, Caroline
中科院分区：
文献类型：
--
作者：
Datta, Jason C.;Janssen, Michael E.;Ponce, Caroline
设计未来的队列。确定单层计算机断层扫描（CT）血管造影在腰椎前路手术患者中确定椎前解剖结构的有效性。术前精确的椎前解剖细节有助于微创腰椎前路手术。共有76名连续患者接受了前路腰椎手术的最小切口入路，在术前进行了CT血管造影评估。记录椎前区解剖，观察治疗过程中患者的情况。没有与CT血管造影相关的并发症。这项研究直接影响了21%患者的手术决策和治疗选择。腔静脉汇合限制了3%的患者进入L5-S1椎间盘，92%的患者进入L4-L5椎间盘。11.8%的患者发现椎前解剖异常。17%的患者发现动脉粥样硬化。主要并发症发生率为7.5%。所有病例的CT血管造影均与术中血管解剖相关。前路手术前CT血管造影被确定为有效评价椎前血管解剖结构。
Design. Prospective cohort.Objective. To determine the efficacy of a single-slice computed tomography (CT) angiogram to define the prevertebral anatomy in patients undergoing an anterior lumbar spine procedure.Summary of Background Data. Preoperative planning with precise prevertebral anatomic details can help in mini-open anterior lumbar approaches.Methods. A total of 76 consecutive patients undergoing a minimal incision approach for anterior lumbar surgery were evaluated before surgery with CT angiography. The prevertebral anatomy was documented, and the patients were observed during treatment.Results. There were no complications related to CT angiography. This study directly influenced surgical decision making and the treatment options in 21% of patients. The vena caval confluence limited access to the L5-S1 disc in 3% of patients and at the L4-L5 disc in 92% of the patients. Prevertebral anatomic anomalies were found in 11.8% of patients. Atherosclerotic disease was discovered in 17% of the patients. The major complication rate was 7.5%. CT angiography correlated with intraoperative vascular anatomy in all cases.Conclusion. Preoperative CT angiography before anterior approaches was determined to be effective in evaluating the prevertebral vascular anatomy.