Measurement and clinical significance of morphological changes of lumbar interlaminar space in different positions
JIANG Hu-shan
ZENG Jian-cheng
ZHU Shu-tao
HUO Shou-song
RUAN Kun-peng
Abstract：Objective By measuring the parameters of lumbar interlaminar space on X-ray films of lumbar spine at different positions,the absolute values and changes were obtained,which provided theoretical basis and guidance for endoscopic posterior lumbar surgery. Methods A total of 106 patients undergoing percutaneous endoscopic interlaminar discectomy (PEID) due to L4-5,L5-S1 lumbar disc herniation in our hospital from June 2022 to December 2023 were collected. Anteroposterior,lateral and flexion-extension X-rays of the lumbar spine were routinely taken before surgery. Anteroposterior and lateral X-rays of lumbar spine were taken during surgery in prone flexion. The height and width of L4-5 and L5-S1 interlaminar space,end-plate angle,and lumbar lordosis angle were measured respectively. Results On the preoperative anteroposterior and lateral X-rays of the lumbar spine,the height,width and end-plate angle of L4-5,L5-S1 interlaminar space were (1.50±0.29) cm,(2.35±0.46) cm,(7.57±3.97) °;(1.68±0.29) cm,(3.03±0.52) cm,(10.67±5.38) °,respectively. And the lumbar lordosis angle was (37.78±15.09) °. The L4-5,L5-S1 flexion X-rays of the lumbar spine end-plate angle and lumbar lordosis angle were (2.61±4.28) °,(6.68±4.49) °,and (17.84±11.46) °. The end-plate angle and lumbar lordosis angle in extension X-rays of the lumbar spine were (8.76±4.75) °,(12.15±5.38) °and (49.35±13.09) °,respectively. On the intraoperative prone flexion anteroposterior and lateral X-rays of the lumbar spine,the height,width and end-plate angle of L4-5,L5-S1 interlaminar space were (1.70±0.31) cm,(2.40±0.46) cm and (6.55±3.79) °;(1.86±0.33) cm,(3.09±0.64) cm,(9.62±5.17) °,respectively. And the lumbar lordosis angle was (31.42±12.17) °. The changes of L4-5,L5-S1 interlaminar height,end-plate angle and lumbar lordosis angle before and during operation were compared,and the differences were statistically significant (P<0.05),which were positively correlated with the changes of end-plate angle and lumbar lordosis angle on the preoperative lumbar functional position film. Conclusions Most L4-5 and L5-S1 interlaminar space are high and wide enough to allow the insertion of a 7 mm endoscopic catheter without bone resection.
Keywords：X-raysIntervertebral disc displacementLumbar vertebraeEndoscopy
Publication Date：2025-01-18
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 10-15 )