Evidence map›Paper›PMID 41188038›Full record

ArticleInternational journal of spine surgery2026

Abd-El-Barr's Mountain-A Radiographic Landmark for Consistent and Successful Docking in Minimally Invasive Lumbar Surgery: A Cadaveric Study.

Mohamed Alwadai, George Borrelli, Favour C Ononogbu-Uche, Meriem Boukhiam, Alyssa Bartlett, Taylor Wallace, Abdullah Saleh, Stephen Bergin, Mazen Zein, Peter Kranz and 1 more

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Article in International journal of spine surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Mohamed AlwadaiDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
George BorrelliDepartment of Orthopedics, Duke University Medical Center, Durham, NC, USA.
Favour C Ononogbu-UcheDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Meriem BoukhiamDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Alyssa BartlettDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Taylor WallaceDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Abdullah SalehDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Stephen BerginDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Mazen ZeinDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Peter KranzDepartment of Radiology, Duke University Medical Center, Durham, NC, USA.
Muhammad Abd-El-BarrDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA m.abdelbarr@duke.eduu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMinimally invasive surgical techniques have the potential to decrease the morbidity associated with traditional open surgery. However, surgeons may hesitate to implement minimally invasive techniques in their practice due to limited direct visualization and an arduous learning curve. Minimally invasive spine surgery requires precise docking of tubular or endoscopic retractors, which is difficult because without direct visualization of surrounding structures, surgeons may find themselves unable to orient themselves. Finding consistent and reproducible radiographic landmarks may decrease barriers to adoption of MISS techniques. Abd-El-Barr's point is a novel radiographic landmark that is identified on lateral fluoroscopy to help with docking for both tubular and endoscopic spine procedures. The landmark is hypothesized to correlate closely with the caudal aspect of the lamina and serve as a reliable docking target.

objectiveTo validate Abd-El-Barr's point as a radiographic landmark for safe, reliable, and consistent docking in minimally invasive lumbar surgery.

methodsA cadaveric study design: fluoroscopic localization of Abd-El-Barr's point was performed bilaterally from L1 to S1 using a sharply pointed instrument that was inserted slightly into the lamina to mark it with a hole, followed by dissection to measure the distance between the mark and the caudal lamina.

resultsA total of 5 cadaveric specimen data were analyzed. The mean distance from Abd-El-Barr's point to the caudal aspect of the lamina across all measured levels and sides was 5.3 mm (bilaterally).

conclusionAbd-El-Barr's point is a reliable radiographic landmark that provides accurate and safe docking during minimally invasive lumbar decompression. Validated through anatomical dissection, it has the potential to standardize docking, provide efficient surgical workflow, and reduce variability across various surgeon experience levels. CLINICAL RELEVANCE: Using this landmark as a docking point, it is hoped that surgeons can make mininally invasive spine surgery, whether tubular or endoscopic, safer and more efficient, thus helping patients recover faster. LEVEL OF EVIDENCE: 5:

Indexed as

cadaveric studylaminalumbar spineminimally invasive spine surgeryspinal endoscopy

Identifiers

PMID41188038
PMCPMC13036467

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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.