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Variation in spatial distance between the lumbar interlaminar window and intervertebral disc space during
Maoqing Fu1,2, Qingchu Li3, Yafei Xu2
1Department of Anatomy, Guangdong Provincial Medical Biomechanical Key Laboratory, Southern Medical University, Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, People's Republic of China.
Surgical and Radiologic Anatomy : SRA
|July 31, 2021
Summary
Lumbar spine flexion increases interlaminar space height and alters the distance to the intervertebral disc space. These dynamic changes are crucial for planning percutaneous endoscopic lumbar discectomy procedures.
Area of Science:
- Spinal anatomy and biomechanics
- Minimally invasive spinal surgery techniques
- Degenerative disc disease research
Background:
- Percutaneous endoscopic discectomy via an interlaminar approach (PED-IL) requires precise knowledge of lumbar anatomy.
- Dynamic changes in the lumbar interlaminar space and its relationship with the intervertebral disc space (IDS) during spinal motion are not well understood.
- Understanding these spatial dynamics is critical for optimizing surgical approaches and patient outcomes.
Purpose of the Study:
- To anatomically clarify dynamic changes in lumbar interlaminar space height (ILH).
- To investigate variations in the distance between the interlaminar space and IDS during lumbar spine flexion-extension.
- To provide data for segment-specific treatment strategies in PED-IL.
Main Methods:
- Utilized a custom-made loading device to create neutral, flexion, and extension 3D lumbar spine models from eight cadaveric specimens.
- Employed 3D reconstruction software for detailed anatomical analysis.
- Measured interlaminar space height (ILH, IL-yH, IL-zH) and the distance to the intervertebral disc space (DpLID) at L3/4, L4/5, and L5/S1 levels.
Main Results:
- Interlaminar space height (ILH) was significantly greater in flexion compared to neutral and extension positions across all lumbar levels.
- Flexion induced significantly greater changes in the distance to the intervertebral disc space (DpLID) from the neutral position than extension.
- While ILH was greatest at L4/5 in the neutral position, differences between levels were not statistically significant.
Conclusions:
- Lumbar spine flexion-extension causes distinct, level-specific alterations in interlaminar space height and its spatial relationship with the intervertebral disc space.
- This study provides valuable anatomical insights into dynamic lumbar spine biomechanics.
- The findings can inform the development of tailored surgical techniques for percutaneous endoscopic interlaminar discectomy.
