The travelling of paravertebral major vessel and its relationship with lumbar spine: a CT report

English Keywords:Spine  Prevertebral vessels  Imaging measurement  CT

English Abstract:

  【Abstract】 Objectives: To observe the paravertebral major vessels and its relationship with lumbar spine, and to provide a theoretical basis for posterior lumbar surgery. Methods: 50 cases underwent enhanced abdominal CT in our hospital, and there were 34 males, with an average age of 53 years, an average height of 174cm, an average weight of 68kg, and 16 females, with an average age of 54 years, an average height of 167cm, an average weight of 63kg. The relationship and distance between lumbar vertebral anterior region and abdominal aorta, inferior vena cava, iliac vein and their branches were measured at the disc plane with PACS 11.0 software system. Meanwhile, the relationship and distance between lumbar vertebral posterior region and abdominal aorta, inferior vena cava, iliac vein and their branches were measured. The relationship between lumbar vertebral(anterior and posterior region) and paravertebral vessels for male and female was measured also. Results: In L1/2-L5/S1, the distance form paravertebral artery to lumbar vertebral anterior border and posterior border was 35.86±7.84mm and 46.48±8.51mm in male, respectively; while in female, the distance was 32.15±6.03mm and 41.57±6.72mm, respectively; the relationship between paravertebral artery and lumbar vertebral anterior and lumbar vertebral posterior region was 10.87°±27.54° and 7.61°±19.12° in male, respectively; while in female, it was 15.16°±31.85° and 10.87°±22.48°, respectively. The distance form paravertebral vein to lumbar vertebral anterior and posterior region was 35.86±7.84mm and 46.48±8.51mm in male, respectively; while it was 32.15±6.03mm and 41.57±6.72mm in female, respectively; the relationship between paravertebral vein and lumbar vertebral anterior and lumbar vertebral posterior region in male was 10.87°±27.54° and 7.61°±19.12°, respectively; while in female, it was 15.16°±31.85° and 10.87°±22.48°, respectively, which showed significant differences between male and female, with male having greater distance of form paravertebral venous to lumbar vertebral anterior border and posterior border than female. However, there was no sex-related significant difference of the relationship between paravertebral venous and lumbar vertebral anterior and posterior region. Abdominal aortic bifurcation in 12 patients(24%) at the lower half of L4, and 32 cases(64%) at the level of L4/5 disc; 29 cases(58%) had llliac artery bifurcation sited at the L5/S1 disc, and 12 cases(24%) at the upper half of the S1 vertebra; 42 cases(84%) had illiac vein confluence sited at the upper half of the L5 vertebra; internal and external iliac vein confluence in 16 patients(33%) located at the L5/S1 disc, and 27 cases(53%) at the lower half of the L5 vertebra. Conclusions: Bifurcation of lumbar paraspinal vascular varies greatly, especially in female. Paravertebral vascular should be paid attention when performing posterior discectomy.