Related Experiment Video
Updated: Aug 16, 2025
05:37
Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
Published on: August 6, 2019
6.4K
Determination of the Entry Point for Lower Lumbar Intradiscal Procedure Using Transforaminal Technique:
Mohd Imran Yusof1,2, Azizul Akram Salim1,2, Joehaimey Johari1,2
1Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
Spine Surgery and Related Research
|December 23, 2022
Summary
This study defines safe instrument angles for transforaminal intradiscal procedures using the Kambin triangle. Findings enhance safety for lumbar spine surgeries at L3/S1 levels.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Radiology
Background:
- The Kambin triangle is a critical safety zone for transforaminal intradiscal procedures.
- Minimizing risks to exiting nerves is paramount during spinal interventions.
Purpose of the Study:
- To enhance understanding of the Kambin triangle's dimensions.
- To improve the safety of transforaminal intradiscal procedures at L3/L4, L4/L5, and L5/S1 levels.
Main Methods:
- A cross-sectional analysis of 102 MRIs was performed.
- Measurements of the Kambin triangle were taken at L3/L4, L4/L5, and L5/S1 disc levels.
- The viability of the transforaminal approach was assessed based on these measurements.
Main Results:
- Safe working zone angles widen progressively from L3 to S1.
- Statistically significant wider angles were observed on the left at L4/L5 and L5/S1.
- Specific entry points and medial inclination angles for lateral, central, and posterior nucleus pulposus, and posterior annulus fibrosus were detailed for each lumbar level.
Conclusions:
- Preoperative MRI assessment is crucial for determining safe trajectory angles.
- This study provides critical data for safe instrument positioning in transforaminal intradiscal procedures.
- The findings contribute to increased safety and efficacy in lumbar spine interventions.
