ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2005
Anatomical study of the paraspinal approach to the lumbar spine.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 61 citations in OpenAlex.
- Trial
- Article
- Occult residual disease after presumed gross-total resection of a predominantly intramuscular paraspinal lumbar schwannoma: a case report introducing the VERIFY-GTR end-of-resection bundle.Journal of spine surgery (Hong Kong) · 2026Article
- Resection of a giant paravertebral retroperitoneal schwannoma via the weaver approach: a case report on technical refinements and surgical considerations.Frontiers in oncology · 2026Article
- The Wiltse paraspinal approach in lumbar surgery: A systematic review.Surgical neurology international · 2026Review
- MRI Evaluation of Paraspinal Muscle Thickness and Interspinous Gap at the Lumbar Level: A Retrospective Cross-sectional Study.Indian journal of orthopaedics · 2025Article
- Short-term clinical efficacy of unilateral biportal endoscopic unilateral laminectomy for bilateral decompression for lumbar epidural lipomatosis: an observational study.BMC musculoskeletal disorders · 2025Observational
- Segmental Interbody, Muscle-Preserving, Ligamentotaxis-Enabled Reduction: "SIMPLER" Technique for cMIS Correction of ASD.International journal of spine surgery · 2025Article
- Article
- Comparison of mMO-TLIF via Midline Incision Versus MIS-TLIF via Wiltse Approach in Lumbar Degenerative Disease.Indian journal of orthopaedics · 2024Article
- Influence of various pilot hole profiles on pedicle screw fixation strength in minimally invasive and traditional spinal surgery: a comparative biomechanical study.Frontiers in bioengineering and biotechnology · 2024Article
- Clinical efficacy and imaging outcomes of unilateral biportal endoscopy with unilateral laminotomy for bilateral decompression in the treatment of severe lumbar spinal stenosis.Frontiers in surgery · 2022Article
- The Clinical Effect of Manual Reduction Combined with Internal Fixation Through Wiltse Paraspinal Approach in the Treatment of Thoracolumbar Fracture.Orthopaedic surgery · 2021Article
- Inconsistent descriptions of lumbar multifidus morphology: A scoping review.BMC musculoskeletal disorders · 2020Article
- Minimally Invasive Far Lateral Lumbar Interbody Fusion: A Prospective Cohort Study.Global spine journal · 2018Article
- Article
- [Trajectory of lumbar and sacral pedicular screws: Comparison between midline versus wiltse approach].Surgical neurology international · 2017Article
- Minimally Invasive Direct Lateral Transpsoas Approach for the Resection of a Lumbar Plexus Schwannoma: Technique Report.Surgery journal (New York, N.Y.) · 2016Article
- Short-term effects of a dynamic neutralization system (Dynesys) for multi-segmental lumbar disc herniation.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2016Article
- Modified minimally invasive transforaminal lumbar interbody fusion using a trans-multifidus approach: a safe and effective alternative to open-TLIF.Journal of orthopaedic surgery and research · 2015Article
Corrections and comments
- Commented on by
Authors and funding
8 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The original description of the paraspinal posterior approach to the lumbar spine was for spinal fusion, especially regarding lumbosacral spondylolisthesis treatment. In spite of the technical details described by Wiltse, exact location of the area where the sacrospinalis muscle has to be split remains somewhat unclear. The goal of this study was to provide topographic landmarks to facilitate this surgical approach. Thirty cadavers were dissected in order to precisely describe the anatomy of the trans-muscular paraspinal approach. The level of the natural cleavage plane between the multifidus and the longissimus part of the sacrospinalis muscle was noted and measurements were done between this level and the midline at the level of the spinous process of L4. A natural cleavage plane between the multifidus and the longissimus part of the sacrospinalis muscle was present in all cases. There was a fibrous separation between the two muscular parts in 55 out of 60 cases. The mean distance between the level of the cleavage plane and the midline was 4 cm (2.4-5.5 cm). In all cases, small arteries and veins were present, precisely at the level of the cleavage plane. We found it possible to easily localize the anatomical cleavage plane between the multifidus part and the longissimus part of the sacrospinalis muscle. First the superficial muscular fascia is opened near the midline, exposing the posterior aspect of the sacrospinalis muscle. Then, the location of the muscular cleft can be found by identifying the perforating vessels leaving the anatomical inter-muscular space.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.