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1、福建医科大学硕士学位论文中可较好保护脊神经根,减少对脊髓硬脊膜的牵拉,可提供充分的手术视野，可行有效的椎管内和椎间孔减压。关键词：肌间隙入路,腰椎,局部解剖,人体标本2福建医科大学硕士学位论文AbstractObjectiveTostudytheanatomyandrelatedparametersofepidural,nerveroots,facetandadjacentstructuresthroughmuscle-splittingapproach.Methods12adultlumbarspinespeci
2、mensweredissectedthroughmuscle-splittingapproachtosimulateminimallyinvasiveprocedureforthetreatmentoflumbarspondylolisthesisandresearchrelatedanatomyofmuscle-splittingapproachandthescopeofexposure.Distancebetweenmusclegapandthemidline,theanglebetweenmusclegapa
3、pproachandmidline,distanceofthebilateralfacetvertexwasmeasured.Surgicaltechniquesofmuscle-splittingapproachwereanalyzed.ResultsAnatomicalstructureswereexposedsatisfactorilythroughmuscle-splittingapproachwithminimaldamagetotheparaspinalsofttissueandbonystructur
4、es.TheaveragedistancebetweenparaspinalWilstegapandthemidlineofL3/4,L4/5,LS/S1wasrespectively32.0mm,35.1mmand40.4mm.ThedistancebetweenWilstegapandmidlineofdifferentvertebrallevelswasstatisticallysignificant(P<0.05).However,therewasnosignificantdifferenceamongdi
5、fferentgendersregardingthedistancebetweenWilstegapandmidline(P>0.05);TheanglebetweenmusclegapapproachandmidlineofL3/4,L4/5andLS/S1wasrespectively15.2°,15.8°and17.3°.Theanglesbetweenmusclegapapproachandmidlineofdifferentlevelswerestatisticallysignificant(P<0.05
6、),buttherewasnostatisticalsignificanceamongtheanglesbetweenmusclegapapproachandmidlineofdifferentgenders.TheaveragedistanceofthebilateralfacetvertexofL3/4,L4/5,LS/S1was29.7mm,34.0mmand36.8mm,andthedifferenceamongdifferentlevelswasstatisticallysignificant(P<0.0
7、5).ConclusionThemuscle-splittingapproachdidpreservetheinterspinalligamentsandsupraspinousligaments,avoidexcessivesplittingparaspinalmuscles,significantlyreducebleedinganddamagetotheposteriorbonystructuresandsofttissues,andmaintainspinalstability.Throughmuscleg
8、apapproach,itwaseasytobetterprotectnerveroots,reducetractionofspinalepidural,provideadequate3福建医科大学硕士学位论文surgicalfieldforeffectivedecompressionofspinalcanalandintervertebralforamen
