Radiographic Study of L5-S1 Transforaminal Endoscopic Access in a Sample from the Brazilian Population.

This study evaluated lumbar spine radiographs using the Choi and Patgaonkar classifications to verify parameters potentially influencing the L5-S1 transforaminal approach.  We studied 167 lumbosacral spine radiographs from patients over 18 years old with no history of surgeries, tumors, fractures, or scoliosis to measure the iliac crest height and rim angle. We categorized the cases per pelvic morphology, mega-apophysis presence, and Choi and Patgaonkar classifications.  Seventy-five cases had an android pelvis and 92 had a gynecoid pelvis. The mean iliac height was 25.9 ± 7.5 cm, and the rim angle was 23.4 ± 7.5 degrees. The gynecoid pelvis showed a lower iliac height. According to Patgaonkar, 63 cases indicated a suprailiac approach, and per the Choi classification, 37 were suitable for a suprailiac approach and 106 for a suprailiac approach with foraminoplasty.  Gynecoid pelvises had a lower iliac height. Furthermore, 37.7% of the cases were suitable for a suprailiac approach per the Patgaonkar classification. The Choi classification indicated a suprailiac approach for 22.1% of the cases and a suprailiac approach with foraminoplasty for 63.4% of the subjects.