Abd-El-Barr's Mountain-A Radiographic Landmark for Consistent and Successful Docking in Minimally Invasive Lumbar...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Surgical Anatomy

Background:

• Minimally invasive spine surgery (MISS) adoption is hindered by visualization challenges and learning curves.
• Accurate docking of retractors is crucial for MISS but difficult without direct visualization.
• Novel radiographic landmarks can simplify MISS procedures and improve surgeon confidence.

Purpose of the Study:

• To validate Abd-El-Barr's point as a radiographic landmark for safe and consistent docking in minimally invasive lumbar surgery.
• To assess the reliability of Abd-El-Barr's point for guiding surgical instrument placement.

Main Methods:

• Cadaveric study involving fluoroscopic localization of Abd-El-Barr's point from L1 to S1.
• Marking the landmark with a hole drilled into the lamina.
• Anatomical dissection to measure the distance from the marked point to the caudal lamina.

Main Results:

• Analysis of 5 cadaveric specimens.
• The mean distance from Abd-El-Barr's point to the caudal lamina was 5.3 mm bilaterally across all levels.
• Consistent and reproducible measurements were obtained.

Conclusions:

• Abd-El-Barr's point is a reliable radiographic landmark for docking in minimally invasive lumbar decompression.
• This landmark can standardize docking, enhance surgical efficiency, and reduce surgeon variability.
• It has the potential to make MISS safer and more efficient, leading to faster patient recovery.