关键词: Biportal endoscopic spine surgery Ligamentum flavum Lumbar lamina Lumbar spine Three-dimensional imaging

来  源:   DOI:10.1007/s00586-024-08270-1

Abstract:
OBJECTIVE: To provide lumbar spine anatomical parameters relevant to the UBE technique and explore their intraoperative application.
METHODS: CT imaging data processed by Mimics for parametric measurements, including laminar abduction angle (LAA), laminar slope angle (LSA), minimum laminar height (MLH), distance between the inferior margin of the lamina and attachment of the ligamentum flavum onto the cephalad lamina (DLL), distance between the initial point and the middle of the articular process (DIA), and distance from the inferior margin of the lamina to the inferior border of the vertebral body (DLV), and were manually measured.
RESULTS: LAA and DIA gradually increase from L1 to L5. At L1, the DIA is approximately the length of 2 drill bits with a diameter of 3 mm (male: 7.77 ± 1.39 mm, female: 7.22 ± 1.09 mm), while at L5, it can reach the length of 4-5 drill bits (male: 14.96 ± 2.24 mm, female: 13.67 ± 2.33 mm). MLH, DLL, and DLV reach their maximum values at the L3 and decrease toward the cranial and caudal ends. The DLL is smallest at L5 (male: 9.58 ± 1.90 mm, female: 9.38 ± 2.14 mm), equivalent to the length of 3 drill bits, while the DLL at L3 is the length of 4-5 drill bits (male: 14.17 ± 2.13 mm, female: 14.01 ± 2.07 mm).
CONCLUSIONS: Referring to the drill diameter during surgery can mark the extent of laminotomy. The characteristics of vertebral plate angles at different lumbar levels can provide references for preoperative incision design.
摘要:
目的:提供与UBE技术相关的腰椎解剖参数,并探讨其术中应用。
方法:由Mimics处理的CT成像数据用于参数测量,包括层流外展角(LAA),层流倾斜角(LSA),最小层流高度(MLH),椎板下缘与黄韧带附着在头椎板(DLL)上的距离,初始点和关节突中间(DIA)之间的距离,从椎板下缘到椎体下缘(DLV)的距离,并手动测量。
结果:LAA和DIA从L1到L5逐渐增加。在L1处,DIA大约是2个直径为3mm的钻头的长度(男性:7.77±1.39mm,女性:7.22±1.09毫米),而在L5,它可以达到4-5钻头的长度(男性:14.96±2.24毫米,女:13.67±2.33mm)。MLH,DLL,DLV在L3处达到最大值,并向颅端和尾端降低。DLL在L5处最小(男性:9.58±1.90毫米,女性:9.38±2.14毫米),相当于3个钻头的长度,而L3处的DLL是4-5钻头的长度(男性:14.17±2.13毫米,女性:14.01±2.07mm)。
结论:在手术过程中参考钻孔直径可以标记椎板切开术的范围。不同腰椎高度椎板角度的特点可为手术前切口设计提供参考。
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