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Related Experiment Videos

Anatomic considerations in lumbar posterolateral percutaneous procedures

S R Mirkovic1, D G Schwartz, K D Glazier

  • 1Department of Orthopaedic Surgery, Northwestern University Medical School, Chicago, Illinois, USA.

Spine
|September 15, 1995
PubMed
Summary

This study determined the safe zones for percutaneous lumbar procedures. Optimal cannula sizes and insertion points were identified to enhance safety in intradiscal interventions.

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Area of Science:

  • Spinal anatomy
  • Minimally invasive spinal surgery

Background:

  • Percutaneous lumbar procedures utilize working cannulas.
  • Literature lacks clarity on safe zones and optimal cannula sizes for these procedures.

Purpose of the Study:

  • Determine the dimensions of the "safe zone" for percutaneous intradiscal procedures.
  • Identify safe insertion points and the largest safe working cannula diameter.

Main Methods:

  • Anatomical dissection of 96 foraminal levels in 12 human cadaveric spines (L2-S1).
  • Measurement of safe zone dimensions and two cannula diameters (C1 and C2) based on insertion points.

Main Results:

  • The average triangular safe zone measured 18.9 mm wide and 12.3 mm high.

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  • Maximum C1 diameter ranged from 5.0-10.0 mm with insertion in the medial one third of the pedicle.
  • Maximum C2 diameter ranged from 4.0-8.9 mm with insertion in the midline of the pedicle.

    • Conclusions:

    • A 7.5-mm cannula in line with the medial one third of the pedicle is safe.
    • A 6.3-mm cannula in the midline of the pedicle is also considered safe.