Evidence map›Paper›PMID 39920319›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025

Anatomy of the diaphragmatic crura and other paraspinal structures relevant to en-bloc spondylectomy for lumbar spine tumours.

Anhelina Khadanovich, Michal Beneš, Radek Kaiser, Jeremy Reynolds, Gerard Mawhinney, Jan Štulík, David Kachlík

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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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. En-bloc spondylectomy at the thoracolumbar junction for primary and metastatic spinal tumors: indications, outcomes and complications in a consecutive series of 22 patients.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 · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Anhelina KhadanovichDepartment of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Michal BenešDepartment of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Radek KaiserDepartment of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic. rkaiser@hotmail.cz.
Jeremy ReynoldsDepartment of Spinal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Gerard MawhinneyDepartment of Spinal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Jan ŠtulíkDepartment of Spinal Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
David KachlíkDepartment of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEn-bloc spondylectomy in the lumbar spine is a challenging procedure mainly due to a complex prevertebral anatomy. The aim of our study is to describe the anatomy of the diaphragmatic crura and surrounding vascular and neural structures which may be iatrogenically injured during the surgical resection. MATERIALS AND

methodsTen embalmed specimens were meticulously dissected. Widths of the diaphragmatic crura, abdominal aorta, cisterna chyli, thoracic duct, sympathetic trunks, and inferior vena cava as well as their distances from the midline were measured at nine levels (L1 to L4 vertebra and adjacent intervertebral discs).

resultsThe right crus was attached to the L2-L4 vertebral bodies and L2/3 intervertebral disc, while the left crus inserted onto L1-L3 vertebrae. The thoracic duct arose commonly at the level of L2 vertebra and overlaid the right crus at the L3 vertebra and L2/3-disc levels. The cisterna chyli was present in 70% of specimens and overlapped with the left crus at the same levels. Both sympathetic trunks emerged underneath the crura at the L1/2 discs or L1 vertebra level. The aorta overlapped with the crura at all levels.

conclusionThe L3 level appears to be the riskiest for spondylectomy due to the overlap of both diaphragmatic crura with the thoracic duct and cisterna chyli, respectively. Spondylectomy at the L2 level also brings the risk of lymphatic structures injury while injury to the left sympathetic trunk may be the main issue at the L1 level.

Indexed as

DiaphragmLumbar VertebraeSpinal NeoplasmsAgedAged, 80 and overAorta, AbdominalCadaverFemaleHumansMaleMiddle AgedThoracic DuctVena Cava, InferiorAbdominal aortaCisterna chyliDiaphragmatic cruraSympathetic trunkThoracic ductTotal en bloc spondylectomy

Identifiers

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Read underepoch 390

Registered trials

None linked

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.