Asian Spine J.  2012 Jun;6(2):98-104. 10.4184/asj.2012.6.2.98.

Radiological Analysis of the Triangular Working Zone during Transforaminal Endoscopic Lumbar Discectomy

Affiliations
  • 1Department of Neurosurgery, Gulhane Military Medical Academy, Ankara, Turkey. civsurgeon@yahoo.com
  • 2Department of Neurosurgery, Baskent University Istanbul Hospital, Istanbul, Turkey.
  • 3Department of Radiology, Gulhane Military Medical Academy, Ankara, Turkey.

Abstract

STUDY DESIGN: Clinical study. PURPOSE: The dimensions of the working zone for endoscopic lumbar discectomy should be evaluated by preoperative magnetic resonance images. The aim of this study was to analyze the angle of the roots, root area, and foraminal area. OVERVIEW OF LITERATURE: Few studies have reported on the triangular working zone during transforaminal endoscopic lumbar discectomy. Many risk factors and restrictions for this procedure have been proposed.
METHODS
Images of 39 patients were analyzed bilaterally at the levels of L3-L4 and L4-L5. Bilateral axial and coronal angles of the roots, root area, and foraminal area were calculated.
RESULTS
No significant difference was observed between the axial angle of the left and right L3 root. A significant difference was found between the axial angle of right and left L4 roots. A significant difference was observed when the coronal angle of the right and left L3 roots were compared, but no significant difference was found when the coronal angle of the right and left L4 roots were compared. No significant difference was observed when the foraminal area of the right and left L3 and L4 roots were compared, but a significant difference was observed when the root area of right and left L3 and L4 roots were compared.
CONCLUSIONS
We suggest that these radiological measurements should be obtained for safety reasons before endoscopic discectomy surgery.

Keyword

Triangular working zone; Endoscopy; Lumbar

MeSH Terms

Diskectomy
Endoscopy
Humans
Magnetic Resonance Spectroscopy
Risk Factors
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