Journal of Shandong University (Health Sciences) ›› 2023, Vol. 61 ›› Issue (3): 90-96.doi: 10.6040/j.issn.1671-7554.0.2022.1217

• 临床医学 • Previous Articles    

Minimally invasive channel of the lumbar spine surgery for Chinese: anatomical data based on CT imaging measurements

ZHAO Geng1*, MAI Ruopeng1*, ZHAO Jingcai2, LIU Xinyu1   

  1. 1. Department of Orthopedics, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Department of Orthopedics, The Second Rehabilitation Hospital of Shandong Province, Taian 271000, Shandong, China
  • Published:2023-03-24

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Abstract: Objective To measure the imaging data of lumbar spine of Chinses, so as to provide anatomical data for the designing of a minimally invasive decompression surgery channel of lumbar vertebrae. Methods Imaging data of 88 consecutive Chinese without related diseases were evaluated, including 40 male and 48 female. Average age was(28.6±5.6)years. The related parameters measured included the width of facet joint from L1 to L5, distance from lateral edge of superior articular process of the inferior vertebra to the root of superior spinous process of the superior vertebra, distance between the lower edge of pedicle of the superior vertebra and the upper edge of pedicle of the inferior vertebra, distance between lower edge of the interverbal disc and the upper edge of pedicle of the inferior vertebra, distance between the upper edge of pedicle of the superior vertebra and the lower edge of pedicle of the inferior vertebra and distance between the lower edge of pedicle of the superior vertebra and the lower edge of pedicle of the inferior vertebra. Results The width of facet joint reached the maximum of 17.6 mm in L4/5 and L5/S1. The distance from the lateral edge of superior articular process of the inferior vertebra to the root of superior spinous process of the superior vertebra reached the maximum of 24.9 mm in L5/S1. The distance between the lower edge of the vertebra of the superior vertebra and the upper edge of pedicle of the inferior vertebra reached the maximum of 19.5 mm in L2/3 and L3/4. The distance between upper edge of the interverbal disc and the upper edge of pedicle of the inferior vertebra reached the maximum of 11.1 mm in L2/3 and L3/4. The distance between the upper edge of pedicle of the superior vertebra and the lower edge of pedicle of the inferior vertebra reached the maximum of 48.5 mm in L1/2 and L2/3. The distance between the lower edge of pedicle of the superior vertebra and the lower edge of pedicle of the inferior vertebra reached the maximum of 34.0 mm in L1/2 and L2/3. Conclusion The surgery channel for minimally invasive decompression of lumbar vertebrae for Chinses lacks statistical support in various parameters, which might cause unnecessary damage during surgery. The research of the anatomical parameters of the lumbar spine has great significance for the design of more suitable minimally invasive surgical channels for Chinese.

Key words: Lumbar, Surgical channel, Chinese, Imaging, Measurement

CLC Number: 

  • R681.5
[1] Foley KT, Holly LT, Schwender JD. Minimally invasive lumbar fusion[J]. Spine(Phila Pa 1976), 2003, 28(15 Suppl): S26-S35.
[2] Wong AP, Smith ZA, Stadler JA, et al. Minimally invasive transforaminal lumbar interbody fusion(MI-TLIF): surgical technique, long-term 4-year prospective outcomes, and complications compared with an open TLIF cohort[J]. Neurosurg Clin N Am, 2014, 25(2): 279-304.
[3] Cloward RB. The treatment of ruptured lumbar intervertebral discs by vertebral body fusion. I. Indications, operative technique, after care[J]. J Neurosurg, 1953, 10(2): 154-168.
[4] Harms J, Rolinger H. A one-stager procedure in operative treatment of spondylolistheses: dorsal traction-reposition and anterior fusion(authors transl)[J]. Z Orthop Ihre Grenzgeb, 1982, 120(3): 343-347.
[5] Foley KT, Gupta SK. Percutaneous pedicle screw fixation of the lumbar spine: preliminary clinical results[J]. J Neurosurg, 2002, 97(Suppl 1): 7-12.
[6] Seng C, Siddiqui MA, Wong KP, et al. Five-year outcomes of minimally invasive versus open transforaminal lumbar interbody fusion: a matched-pair comparison study[J]. Spine(Phila Pa 1976), 2013, 38(23): 2049-2055.
[7] Patel AA, Zfass-Mendez M, Lebwohl NH, et al. Minimally invasive versus open lumbar fusion: a comparison of blood loss, surgical complications, and hospital course[J]. Iowa Orthop J, 2015, 35: 130-134.
[8] Parker SL, Mendenhall SK, Shau DN, et al. Minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis: comparative effectiveness and cost-utility analysis[J]. World Neurosurg, 2014, 82(1/2): 230-238.
[9] Xie L, Wu WJ, Liang Y. Comparison between minimally invasive transforaminal lumbar interbody fusion and conventional open transforaminal lumbar interbody fusion: an updated meta-analysis[J]. Chin Med J(Engl), 2016, 129(16): 1969-1986.
[10] Barbagallo GM, Yoder E, Dettori JR, et al. Percutaneous minimally invasive versus open spine surgery in the treatment of fractures of the thoracolumbar junction: a comparative effectiveness review[J]. Evid Based Spine Care J, 2012, 3(3): 43-49.
[11] 朱友余, 邓雪飞. 腰椎微创脊柱外科研究进展[J]. 局解手术学杂志, 2017, 26(1): 69-73. ZHU Youyu, DENG Xuefei. Research progress of minimally invasive surgery for lumbar spine[J]. Journal of Regional Anatomy and Operative Surgery, 2017, 26(1): 69-73.
[12] Hu W, Tang J, Wu X, et al. Minimally invasive versus open transforaminal lumbar fusion: a systematic review of complications[J]. Int Orthop, 2016, 40(9): 1883-1890.
[13] Tabaraee E, Ahn J, Bohl DD, et al. Quantification of multifidus atrophy and fatty infiltration following a minimally invasive microdiscectomy[J]. Int J Spine Surg, 2015, 9: 25. doi:10.14444/2025.
[14] 李士学, 张为, 孙亚澎, 等. 两种通道下MIS-TLIF治疗退变性腰椎管狭窄症的对比研究[J]. 中华骨科杂志, 2019, 39(20): 1275-1284. LI Shixue, ZHANG Wei, SUN Yapeng, et al. A comparison study of two channels during MIS-TLIF in degenerative lumbar spinal Stenosis treatment[J]. Chinese Journal of Orthopaedics, 2019, 39(20): 1275-1284.
[15] Krag MH, Beynnon BD, Pope MH, et al. Depth of insertion of transpedicular vertebral screws into human vertebrae: effect upon screw-vertebra interface strength[J]. J Spinal Disord, 1988, 1(4): 287-294.
[16] Datir SP, Mitra SR. Morphometric study of the thoracic vertebral pedicle in an Indian population[J]. Spine(Phila Pa 1976), 2004, 29(11): 1174-1181.
[17] 韩华, 项燕, 韩佳栩, 等. 不同国家人群胸椎椎弓根解剖结构的对比研究[J]. 中国临床解剖学杂志, 2018, 36(3): 252-258. HAN Hua, XIANG Yan, HAN Jiaxu, et al. Comparative research of anatomical structures of human thoracic pedicle in different countries[J]. Chinese Journal of Clinical Anatomy, 2018, 36(3): 252-258.
[18] Lv Y, Chen JY, Chen JC, et al. Three-year postoperative outcomes between MIS and conventional TLIF in1-segment lumbar disc herniation[J]. Minim Invasive Ther Allied Technol, 2017, 26(3): 168-176.
[19] 李高峰, 郑卫东, 李光淳, 等. 成人下胸椎、腰椎椎弓根的多排螺旋CT测量与临床意义[J]. 吉林医学, 2014, 35(10): 2131-2133.
[20] 汤优, 张为, 申勇, 等. 经Quadrant通道下微创TLIF与开放TLIF治疗腰椎退变性疾病疗效的对比研究[J]. 中国矫形外科杂志, 2012, 20(21): 1935-1938. TANG You, ZHANG Wei, SHEN Yong, et al. Retrospective clinical comparison of transforaminal lumbar interbody fusion via Quadrant minimally invasive system versus open transforaminal lumbar interbody fusion in the treatment of lumbar degenerative disease[J]. Orthopedic Journal of China, 2012, 20(21): 1935-1938.
[21] Hammad A, Wirries A, Ardeshiri A, et al. Open versus minimally invasive TLIF: literature review and meta-analysis[J]. J Orthop Surg Res, 2019, 14(1): 229.
[22] Xie Q, Zhang J, Lu F, et al. Minimally invasive versus open Transforaminal lumbar Interbody fusion in obese patients: a meta-analysis[J]. BMC Musculoskelet Disord, 2018, 19(1): 15.
[23] Ryu DS, Ahn SS, Kim KH, et al. Does minimally invasive fusion technique influence surgical outcomes in isthmic spondylolisthesis?[J]. Minim Invasive Ther Allied Technol, 2019, 28(1): 33-40.
[24] Peng P, Chen K, Chen H, et al. Comparison of O-arm navigation and microscope-assisted minimally invasive transforaminal lumbar interbody fusion and conventional transforaminal lumbar interbody fusion for the treatment of lumbar isthmic spondylolisthesis[J]. J Orthop Translat, 2019, 20:107-112. doi:10.1016/j.jot.2019.10.001.
[25] 李振宙, 侯树勋. 腰椎退行性疾病微创外科治疗概况及展望[J]. 中国骨与关节杂志, 2022, 11(9): 641-647. LI Zhenzhou, HOU Shuxun. Overview and prospect of minimally invasive surgical treatment of lumbar degenerative diseases[J]. Chinese Journal of Bone and Joint, 2022, 11(9): 641-647.
[26] Roberti F, Arsenault KL. Minimally invasive tubular laminectomies in multilevel spine surgery-an illustrative case-based review of techniques and combined approaches[J]. J Spine Surg, 2021, 7(1): 83-99.
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