Morphometric analysis of lumbar arteries and relationship with intervertebral discs\', a study of surgical anatomy on human fresh cadavers..

Abstract

AIM: To examine the morphological structure of anterior lumbar spinal region. MATERIAL and METHODS: Fifteen fresh human cadavers were studied in our forensic medicine institution. Within the first 24 hours after death, cadavers were subject to a routine autopsy, by which the intestines were removed and the structures adjacent to the lumbar arteries (LAs) were examined. The following characteristics of the LA were examined and recorded: diameter, number of LA, intervertebral disc, and vertebral corpus relationship, and LA anatomical variations. RESULTS: In 14 of the 15 cadavers (93.3%), the first four LAs originated from the abdominal aorta. In one (6.7%) cadaver, the fourth LA originated from the right aortic trunk together with the median sacral artery (MSA), and this was observed only in the right side. In one cadaver, the first LAs emerged as a common trunk. Twelve cadavers did not have a fifth LA. In one cadaver (6.7%), the fifth LAs emerged as in a pair, distally from the origin of the MSA. Two cadavers (13.3%) had fifth LAs that emerged from the common trunk with the MSA and this occurred only on the right side. LAs which emerged from the right side of the abdominal aorta passed under the inferior vena cava. Of the first four LA, the third LA had the largest vessel diameter, and the first LA had the narrowest vessel diameter. Fifth LAs had one of the narrowest vessel diameters of all LAs. CONCLUSION: We consider that anatomical study of LAs using fresh cadavers can be useful to ensure safer anterior lumbar spinal surgeries.

Morphometric analysis of the lumbar vertebrae and intervertebral discs in relation to abdominal aorta: CT-based study

“…There are a lot of studies discussing vascular injury in spine surgery. Vascular complications can occur with an incidence of 1–5 in 10,000 disc operations, they most commonly appear at the L4/L5 level, result in arteriovenous fistulas and predominantly concern injury of common iliac artery, aorta or lumbar arteries [ 5 , 22 ]. Majority of works discuss that problem only in anterior approach procedures [ 5 , 7 , 9 , 15 , 18 , 31 ].…”

“…Vascular complications can occur with an incidence of 1–5 in 10,000 disc operations, they most commonly appear at the L4/L5 level, result in arteriovenous fistulas and predominantly concern injury of common iliac artery, aorta or lumbar arteries [ 5 , 22 ]. Majority of works discuss that problem only in anterior approach procedures [ 5 , 7 , 9 , 15 , 18 , 31 ]. Nowadays, the posterior approach is considered to minimalize the chance of vascular injury, but it still does not eliminate it—more often it provides long-term complications which can be challenging to diagnose [ 14 , 19 , 20 , 23 ].…”

Anatomical Variations of The Fifth Lumbar Artery in A Sample Kenyan Population

“…The fifth lumbar arteries from our study originated directly from the aorta with 50% arising as one common stem and branching into two, while 50% arose singly. Most previous studies have reported that the fifth lumbar arteries originate from the middle sacral artery or the aorta (2,14,16,17). This may be due to the embryological development of the intersegmental branches of the dorsal aorta in the fetus.…”