Applied anatomy of segmental vessels and nerves around T_(4～12) vertebra

Objective: To look for a relative region for T4~12 anterior spine surgery assisted by thoracoscopy,and collect anatomical parameters to facilitate the intraoperative localization and the prevention of complications.Methods: 30 normal adult cadavers were selected randomly in the anatomical study.To observe anatomic characteristics of segmental vessels in T4~12 segments,the distance from the right rib head to the azygos vein and to the right sympathetic trunk,the distance from the left rib head to the deputy azygos vein,the accessory deputy azygos vein,the thoracic aorta and the left sympathetic trunk were measured.The distances from adjacent segmental vessels to the superior or inferior border of the intervertebral discs and thedistances among adjacent segmental vessels,were measured on the middle line at the lateral face of T4~12 vertebral body.Results: There was a safe region in which no important vessel and nerve appeared on the both sides of lateral face of T4~12 vertebra,with the biggest and smallest area of(24.25×44.74) mm2 and(19.74×28.43)mm2,and of(29.14×23.22) mm2 and(21.87×7.43) mm2 for the right and left respectively.Conclusions:(1) A relative region locates at the lateral face of the vertebral bodies of T4~12.(2) It is preferred to select the right approach during the anterior thoracic spine operation assisted by thoracoscopy,which is better for exposing and operating.