科研之友
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摘要
To observe the morphology character of the anterior epidural space at the L4-5 disc level and to provide an anatomical basis for safely and accurately performing a percutaneous endoscopic lumbar discectomy (PELD). Fifty-five cases with L5S1 lumbar disc herniation were included in this study, and cases with L4-5 disease were excluded. When the puncture needle reached the epidural space at the L5S1 level, iohexol was injected at the pressure of 50 cm H2O during the PELD, then C-Arm fluoroscopy was used to obtain standard lumbar frontal and lateral images. The widths of epidural space at the level of the L-4 lower endplate, the L-5 upper endplate, as well as the middle point of the L4-5 disc were measured from the lumbar lateral X-ray film. Epidural space at the L4-5 disc plane performs like a trapezium chart with a short side at the head end and a long side at the tail end in the lumbar lateral X-ray radiograph, while the average widths of epidural space were 10.2 +/- 2.5, 12.3 +/- 2.3, and 13.8 +/- 2.6 mm at the upper, middle, and lower level of the L4-5 disc. Understanding the morphological characteristics of epidural space will contribute to improving the safety of the tranforaminal percutaneous endoscopy technique.
