title: Course of major paravertebral vessels and the positional relationship to the vertebral bodies in healthy Chinese subjects: a CT-based study.
abstract: BACKGROUND
  Several studies, including those done in China, report that paravertebral vascular injury during posterior spinal surgery can greatly harm patients, though it is a relatively rare complication. However, few studies have examined their course and anatomic relationship to the spine. The aim of this study was to measure the course of the major paravertebral vessels and their positional relationships to the vertebral bodies in Chinese subjects using computed tomography.
  
  
  METHODS
  We studied a total of fifty subjects who underwent thoracolumbar computed tomography from T1-S1 at our institution. We measured the theoretical distance, actual distance, theoretical angle, and actual angle of the paravertebral vessels at each thoracolumbar intervertebral disc.
  
  
  RESULTS
  The paravertebral artery actual angle at T4-L4 ranged from -11.41 to 79.75° and the actual distance from 16.98 to 52.53 mm. The actual angle of the inferior vena cava at L1-L5 intervertebral disc ranged from -40.75 to 34.50° and the actual distance from -36.63 to 61.69 mm. There was no significant difference in the actual angle of the paravertebral vein or in the actual distance in the thoracic segments according to gender (P > 0.05). However, the actual distance in the lumbar segments were significantly different according to gender (P < 0.05).
  
  
  CONCLUSIONS
  The major paravertebral vessels' course is closer to the mid-sagittal plane as they move posterior along the vertebrae, and the actual distance of the paravertebral artery and azygos vein increase, while the actual distance of the inferior vena cava decreases. The course of the lumbar paravertebral vessels varies, especially at L4/L5, and may be more prone to intraoperative injury in female subjects.
authors.affiliation: Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing 100029, China.
authors.forename: Fuqiang
authors.initials: F
authors.lastname: Gao
authors.affiliation: Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing 100029, China.
authors.forename: Xuanji
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing 100029, China.Email: 18901267995@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Sun
authors.affiliation: Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing 100029, China.
authors.forename: Pradhan
authors.initials: P
authors.lastname: Abhinav
authors.affiliation: Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing 100029, China.
authors.forename: Zirong
authors.initials: Z
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D001158:Arteries / Q000293:injuries; D001401:Azygos Vein / Q000000981:diagnostic imaging / Q000293:injuries; D005260:Female; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging / Q000293:injuries; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D055815:Young Adult