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Quantitative Anatomic Analysis and Clinical Application of Lumbar Spinous Process Split Laminotomy
Ji Xu1, Runpei Wang, Xiaodong Wang
1Dalian Medical University, Department of Clinical Medicine, Liaoning, China.
Turkish Neurosurgery
|March 18, 2024
Summary
Lumbar spinous process split laminotomy is feasible and safe using a 10-12 mm retraction width. This technique provides adequate surgical corridors for complex procedures, with a safety margin up to 16.82 mm to prevent bony fractures.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Anatomical Studies
Background:
- Lumbar spinous process split laminotomy is a surgical technique.
- Quantitative anatomical analysis is crucial for assessing surgical feasibility and safety.
Purpose of the Study:
- To investigate the feasibility and safety of lumbar spinous process split laminotomy.
- To perform a quantitative anatomical analysis of surgical corridors and safety margins.
Main Methods:
- Nine fresh adult human cadaveric specimens (45 lumbar segments) were used.
- Simulated operations evaluated surgical corridors at 8 mm, 10 mm, and 12 mm retraction widths.
- The safety margin for retraction width was determined by measuring the width causing bony fracture.
Main Results:
- A 10-12 mm retraction width provided adequate surgical corridors for procedures.
- A 12 mm retraction width offered a larger corridor and shorter operative time than 10 mm.
- The bony fracture safety margin ranged from 12.34 mm to 16.82 mm, with fractures occurring primarily in the pedicle.
Conclusions:
- A retraction width of 10-12 mm is safe and effective for lumbar spinous process split laminotomy.
- Micromanipulations like tumor resection and dural repair are feasible within the established corridors.
- The determined safety margin aids in surgical planning for this procedure.
