An anatomy study of operative approach of laparoscopic lower lumbar spine surgery

Objective To study the anatomic characteristics of blood vessels situated at the lower lumbar spine and to provide anatomic data for laparoscopic lumbar surgery.Methods 15 formal dehyde-preserved cadavers were studied with special attention to the blood vessels of lower lumbar,and the anatomic data were recorded and calculated.Results Abdominal aorta and its branches or inferior vena cava and its tributaries situated in front of L3～4 disc and L4～5 disc.It was difficult to expose the L3～4 disc and L4～5 disc by distracting Large vessels.But there were enough area for operation from anterolateral of L3～4 disc and L4～5 disc.Also,it was satisfactory to expose L5～S1 disc from the area of ∧between left common iliac vein and right common iliac artery.Conclusions It is feasible for lower lumbar spine surgery under laparoscope.It is better to reveal L3～4 disc and L4～5 disc through the retroperitoneal cavity and to reveal the L5～S1 disc by peritoneal approach.