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European Spine Journal

29-04-2024 | Laminotomy | Original Article

Imaging anatomy study related to unilateral biportal endoscopic lumbar spine surgery

Authors: Shengxuan Hu, Jingwen Zhang, Weibo Zeng, Zhemin Zhu, Shuai Wang, Zhaowei Lin, Benchao Shi

Published in: European Spine Journal

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Abstract

Purpose

To provide lumbar spine anatomical parameters relevant to the UBE technique and explore their intraoperative application.

Methods

CT imaging data processed by Mimics for parametric measurements, including laminar abduction angle (LAA), laminar slope angle (LSA), minimum laminar height (MLH), distance between the inferior margin of the lamina and attachment of the ligamentum flavum onto the cephalad lamina (DLL), distance between the initial point and the middle of the articular process (DIA), and distance from the inferior margin of the lamina to the inferior border of the vertebral body (DLV), and were manually measured.

Results

LAA and DIA gradually increase from L1 to L5. At L1, the DIA is approximately the length of 2 drill bits with a diameter of 3 mm (male: 7.77 ± 1.39 mm, female: 7.22 ± 1.09 mm), while at L5, it can reach the length of 4–5 drill bits (male: 14.96 ± 2.24 mm, female: 13.67 ± 2.33 mm). MLH, DLL, and DLV reach their maximum values at the L3 and decrease toward the cranial and caudal ends. The DLL is smallest at L5 (male: 9.58 ± 1.90 mm, female: 9.38 ± 2.14 mm), equivalent to the length of 3 drill bits, while the DLL at L3 is the length of 4–5 drill bits (male: 14.17 ± 2.13 mm, female: 14.01 ± 2.07 mm).

Conclusion

Referring to the drill diameter during surgery can mark the extent of laminotomy. The characteristics of vertebral plate angles at different lumbar levels can provide references for preoperative incision design.
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Metadata
Title
Imaging anatomy study related to unilateral biportal endoscopic lumbar spine surgery
Authors
Shengxuan Hu
Jingwen Zhang
Weibo Zeng
Zhemin Zhu
Shuai Wang
Zhaowei Lin
Benchao Shi
Publication date
29-04-2024
Publisher
Springer Berlin Heidelberg
Keyword
Laminotomy
Published in
European Spine Journal
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-024-08270-1