ArticleJournal of orthopaedic surgery and research2024
Transforaminal posterior lumbar interbody fusion microscopic safe operating area: a three-dimensional model study based on computed tomography imaging.
Article in Journal of orthopaedic surgery and research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Oblique lumbar interbody fusion versus posterior lumbar interbody fusion for adjacent segment disease following prior lumbar fusion: a meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- One-hole split endoscopy versus unilateral biportal endoscopy for lumbar degenerative disease: a systematic review and meta-analysis of clinical outcomes and complications.Journal of orthopaedic surgery and research · 2025Pooled it
- Application of an enhanced recovery after surgery care protocol in patients undergoing lumbar interbody fusion surgery: a meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Clinical Study of Ultrasound-Guided Modified Percutaneous Endoscopic Interlaminar Discectomy Combined With Medical Chitosan in Lumbar 4-5 Disc Herniation Treatment.Orthopaedic surgery · 2026Trial
- Interspinous process fixation versus posterior lumbar interbody fusion following decompression for single-level grade I degenerative spondylolisthesis: a retrospective propensity score-matched study.Journal of orthopaedic surgery and research · 2026Article
- Impact of cage position in posterior lumbar interbody fusion on cage subsidence in patients with asymmetric Modic changes and analysis of related risk factors.Journal of orthopaedic surgery and research · 2026Article
- Innovative method for efficient placement of a working cannula in uniportal transarticular full-endoscopic lumbar interbody fusion: transarticular trephonic plasty (TTP).BMC musculoskeletal disorders · 2026Article
- Risk factors for postoperative ileus following transforaminal lumbar interbody fusion: a retrospective study.Journal of orthopaedic surgery and research · 2025Article
- Comparative outcomes of midline lumbar fusion and minimally invasive transforaminal lumbar interbody fusion in osteoporotic L4/5 spinal stenosis: a two-year retrospective study.Journal of orthopaedic surgery and research · 2025Article
- Force-limited distance-measurable nerve root retractor plus intraoperative neurophysiological monitoring reduces L5 radiculitis in posterior lumbar interbody fusion.Journal of orthopaedic surgery and research · 2025Article
- Early-stage lumbar paraspinal muscle injury: endoscopic versus transforaminal lumbar interbody fusion: a retrospective comparative analysis.Journal of orthopaedic surgery and research · 2025Article
- Modified frailty index predicts postoperative outcomes of Chinese elderly patients undergoing transforaminal lumbar interbody fusion.Journal of orthopaedic surgery and research · 2025Article
- Comparison of short-term clinical outcomes and muscle injury in patients with lumbar spinal stenosis undergoing arthroscopic-assisted uni-portal spinal surgery, unilateral biportal endoscopic surgery, and percutaneous interlaminar lumbar discectomy: a six-month follow-up.Journal of orthopaedic surgery and research · 2025Article
- Advantages of a new improved oblique Retractor in oblique lateral lumbar interbody fusion: a retrospective study.Journal of orthopaedic surgery and research · 2025Article
- Demineralized bone matrix combined with concentrated growth factors promotes intervertebral fusion in a novel rat extreme lateral interbody fusion model.Journal of orthopaedic surgery and research · 2025Article
- Analyses of proximal adjacent segment degeneration and prognostic factors after lumbar fusion surgery: study based on proximal facet joint angle.Journal of orthopaedic surgery and research · 2025Article
- Comparison of clinical efficacy and radiological findings of interspinous dynamic stabilization system versus unilateral biportal endoscopy for lumbar spinal stenosis: a retrospective cohort study.Journal of orthopaedic surgery and research · 2025Article
- The impact of preoperative handgrip strength on postoperative outcomes following transforaminal lumbar interbody fusion.Journal of orthopaedic surgery and research · 2025Observational
- Full-endoscopic posterior lumbar interbody fusion for the treatment of lumbar degenerative diseases: a technical note with 2-year follow-up.Journal of orthopaedic surgery and research · 2025Article
- The risk factors for low back pain following oblique lateral interbody fusion: focus on sarcopenia.Journal of orthopaedic surgery and research · 2025Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundEndoscopic spine lumbar interbody fusion (Endo-LIF) is well-regarded within the academic community. However, it presents challenges such as intraoperative disorientation, high rates of nerve damage, a steep learning curve, and prolonged surgical times, often occurring during the creation of the operative channel. Furthermore, the undefined safe operational zones under endoscopy continue to pose risks to surgical safety. We aimed to analyse the anatomical data of Kambin's triangle via CT imaging to define the parameters of the safe operating area for transforaminal posterior lumbar interbody fusion (TPLIF), providing crucial insights for clinical practice.
methodsWe selected the L4-L5 intervertebral space. Using three-dimensional (3D), we identified Kambin's triangle and the endocircle within it, and recorded the position of point 'J' on the adjacent facet joint as the centre 'O' of the circle shifts by angle 'β.' The diameter of the inscribed circle 'd,' the abduction angle 'β,' and the distances 'L1' and 'L2' were measured from the trephine's edge to the exiting and traversing nerve roots, respectively.
resultsUsing a trephine with a diameter of 8 mm in TPLIF has a significant safety distance. The safe operating area under the TPLIF microscope was also clarified.
conclusionsThrough CT imaging research, combined with 3D simulation, we identified the anatomical data of the L4-L5 segment Kambin's triangle, to clarify the safe operation area under TPLIF. We propose a simple and easy positioning method and provide a novel surgical technique to establish working channels faster and reduce nerve damage rates. At the same time, according to this method, the Kambin's triangle anatomical data of the patient's lumbar spine diseased segments can be measured through CT 3D reconstruction of the lumbar spine, and individualised preoperative design can be conducted to select the appropriate specifications of visible trephine and supporting tools. This may effectively reduce the learning curve, shorten the time operation time, and improve surgical safety.
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