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Imaging anatomy study related to unilateral biportal endoscopic lumbar spine surgery

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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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Author information

Author notes

  1. Shengxuan Hu and Jingwen Zhang have contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Spine Surgery, Zhujiang Hospital, Southern Medical University, 253 Gongye Road, Guangzhou, 510282, China

    Shengxuan Hu, Jingwen Zhang, Weibo Zeng, Zhemin Zhu, Shuai Wang & Benchao Shi

  2. Department of Joint Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China

    Zhaowei Lin

Authors
  1. Shengxuan Hu
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  2. Jingwen Zhang
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  3. Weibo Zeng
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  4. Zhemin Zhu
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  5. Shuai Wang
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  6. Zhaowei Lin
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  7. Benchao Shi
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Correspondence to Zhaowei Lin or Benchao Shi.

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Hu, S., Zhang, J., Zeng, W. et al. Imaging anatomy study related to unilateral biportal endoscopic lumbar spine surgery. Eur Spine J (2024). https://doi.org/10.1007/s00586-024-08270-1

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