Gill T J, Mason M D
Department of Orthopedic Surgery, Harvard Medical School, USA.
Clin Orthop Relat Res. 1998 Mar(348):135-9.
Surgical decompression of spinal stenosis is a balance between adequate removal of bone and soft tissue for an effective decompression of neural structures and a sufficient retention of bone to maintain mechanical stability of the spine. To develop an objective, reproducible technique for the assessment of neuroforaminal decompression in the adult lumbar spine, facet sparing laminectomies were performed from L1-S1 on the lumbar spines of 59 human cadavers. A series of semirigid probes in 0.5-mm increments were passed into each successive intervertebral foramen bilaterally, beginning at L2-L3. The minimum space available for the nerve root within the foramen of the lumbar spine is 3.5 mm at L2-L3, 3.9 mm at L3-L4, 4.3 mm at L4-L5 and 5.1 mm at L5-S1, as determined by three independent observers. There were no significant differences in interobserver or intraobserver measurements. There were no complications related to passage of the probes. This study provides a method for the intraoperative determination of the adequacy of neuroforaminal decompression.
脊柱狭窄的手术减压是在充分去除骨骼和软组织以有效减压神经结构与充分保留骨骼以维持脊柱机械稳定性之间取得平衡。为了开发一种客观、可重复的技术来评估成人腰椎的神经孔减压情况，对59具人类尸体的腰椎进行了L1 - S1节段的保留关节突椎板切除术。从L2 - L3开始，一系列以0.5毫米递增的半刚性探针双侧依次插入每个椎间孔。由三名独立观察者确定，腰椎椎间孔内神经根的最小可用空间在L2 - L3为3.5毫米，L3 - L4为3.9毫米，L4 - L5为4.3毫米，L5 - S1为5.1毫米。观察者间或观察者内测量无显著差异。探针插入未出现相关并发症。本研究提供了一种术中确定神经孔减压是否充分的方法。
