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与内镜手术相关的骨性坎宾三角的尺寸

Dimensions of bony Kambin's triangle pertaining to endoscopic procedure.

作者信息

Sinha Manisha B, Rachel John Meryl, Abraham Poonuraparampil Joseph, Prasad Sinha Human

机构信息

Additional Professor (Anatomy), AIIMS Raipur, Chhattisgarh, India.

Senior Resident (Anatomy), AIIMS Raipur, Chhattisgarh, India.

出版信息

Med J Armed Forces India. 2024 Dec;80(Suppl 1):S127-S134. doi: 10.1016/j.mjafi.2022.12.018. Epub 2023 Mar 21.

Abstract

BACKGROUND

Endoscopic procedures nowadays are successful, minimally invasive, and safer, with fewer intraoperative and postoperative complications and shorter hospital stays. Kambin's triangle (KT) is the three-dimensional configuration that is used as a transforaminal anatomical corridor for epidural steroid injections and endoscopic surgeries for various lumbar pathologies. This study aims to estimate the dimensions of KT and diameter of the cannula for the transforaminal surgical approaches using KT in the Chhattisgarh population.

METHODS

Seven human cadavers (three males and four females) were included in the study for observing KT. Dissection was done to carefully clear landmarks, including the vertebral bodies, intervertebral disc, exiting nerve root, and superior articular process. Base (a horizontal plane passing through the superior border of the caudal vertebra) and height (along the superior articular process of the inferior vertebra in line with the articular facet) were measured. Hypotenuse, semiperimeter of the triangle, area of triangle, diameter, and area of the inscribed circle were calculated.

RESULTS

Height, base, and inscribed circle diameter increased from L1-L2 to L4-L5 then decreased to L5-S1. There was no statistically significant difference between males and females. The safest admissible cannula diameter according to the current study that can be used at all levels in KT was 6.06 mm.

CONCLUSION

This study provides the safest cannula size to be considered in the patients of the Chhattisgarh population during transforaminal approaches in the lumbar area. Minimally invasive surgery and shorter hospitalization are vital criteria to evaluate any surgery these days.

摘要

背景

如今,内镜手术成功率高、创伤小且更安全,术中及术后并发症更少,住院时间更短。坎宾三角(KT)是一种三维结构,用作经椎间孔硬膜外类固醇注射及针对各种腰椎疾病的内镜手术的解剖通道。本研究旨在评估恰蒂斯加尔邦人群中使用KT进行经椎间孔手术入路时KT的尺寸及套管直径。

方法

本研究纳入七具人类尸体(三男四女)以观察KT。进行解剖以仔细清理包括椎体、椎间盘、穿出神经根和上关节突在内的标志。测量底边(穿过尾椎上缘的水平面)和高度(沿着下椎骨与关节面一致的上关节突)。计算斜边、三角形半周长、三角形面积、直径和内切圆面积。

结果

高度、底边和内切圆直径从L1-L2至L4-L5逐渐增加,然后降至L5-S1。男女之间无统计学显著差异。根据本研究,KT各节段均可使用的最安全的可允许套管直径为6.06毫米。

结论

本研究提供了恰蒂斯加尔邦人群在腰椎经椎间孔入路手术中应考虑的最安全的套管尺寸。如今,微创手术和缩短住院时间是评估任何手术的关键标准。

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