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The position of the aorta relative to the spine: is it mobile or not?

机译：主动脉相对于脊柱的位置：是否可移动？

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STUDY DESIGN: This study analyzes the mobility of the aorta relative to the spine in patients with a herniated thoracic disc requiring surgical intervention. OBJECTIVES: To determine the mobility of the aorta relative to the spine with the patient in prone and supine position. SUMMARY OF BACKGROUND DATA: In anterior scoliosis surgery, safe screw placement is important and knowledge of the position of the aorta relative to the spine is crucial. To the authors' knowledge, there are no studies on the mobility of the aorta relative to the spine with the patient in different positions. METHODS: All 50 patients before surgery had a computed tomography (CT) and/or magnetic resonance (MR) scans of the involved spinal segment in supine position, as well as a CT with intrathecal contrast in prone position. The aorta-vertebral angle and the aorta-vertebral distance were measured on as many levels as possible. RESULTS: In supine position, the aorta is positioned left lateral to the vertebral body at midthoracic levels (T4-T8) and more anterior to the vertebral body at lower thoracic levels (T9-L2). In prone position, the aorta moves to a more anteromedial position relative to the vertebra, which is most significant at levels T4 to T8. The mediolateral aorta-vertebral distance according to Sevastik is shorter in prone position, whereas the anterior-posterior distance according to Sucato is larger, especially at levels T5 to T10. CONCLUSIONS: We demonstrate a substantial difference in the position of the aorta relative to the spine in prone and in supine position, which is most markedly seen at levels T4 to T8. The aorta is positioned posterolateral to the spine in supine position and more anteromedial in prone position. Before performing anterior thoracolumbar spine surgery, we suggest to measure vertebral body width, as well as the position of the aorta in the prone and in the supine patient to decide if his approach is technically feasible, or if an alternative (contralateral) approach is preferable.
机译：研究设计：这项研究分析了需要手术干预的患有椎间盘突出的患者的主动脉相对于脊柱的活动性。目的：确定患者俯卧和仰卧位时主动脉相对于脊柱的活动性。背景数据摘要：在前路脊柱侧弯手术中，安全地放置螺钉很重要，并且了解主动脉相对于脊柱的位置至关重要。据作者所知，尚无关于患者处于不同位置的主动脉相对于脊柱活动性的研究。方法：术前所有50例患者均在仰卧位对受累脊柱进行了计算机断层扫描（CT）和/或磁共振（MR）扫描，在俯卧位进行了鞘内造影。在尽可能多的水平上测量主动脉-椎骨角度和主动脉-椎骨距离。结果：在仰卧位，主动脉在椎体中部水平（T4-T8）位于椎体的左侧，在椎体较低的水平处（T9-L2）位于椎体的更前方。在俯卧位置，主动脉相对于椎骨移到更内侧的位置，这在T4到T8的水平上最为明显。根据Sevastik，在俯卧位时，中外侧主动脉-椎骨距离较短，而根据Sucato，其前后距离较大，尤其是在T5至T10水平。结论：我们证明了俯卧和仰卧位的主动脉相对于脊柱的位置存在显着差异，这在T4至T8级最为明显。主动脉仰卧位位于脊柱后外侧，俯卧位位于前内侧。在进行胸腰椎前路脊柱手术之前，我们建议测量椎体宽度，以及俯卧和仰卧患者的主动脉位置，以决定他的方法在技术上是否可行，或者是否可以选择其他方法（对侧） 。

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