The location of the intervertebral lumbar disc on the posterior aspect of the spine
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Spinal sonography and central neuraxial blocks
2023, Best Practice and Research: Clinical AnaesthesiologyEarly Clinical Outcomes of Percutaneous Endoscopic Lumbar Discectomy for L4-5 Highly Down-Migrated Disc Herniation: Interlaminar Approach Versus Transforaminal Approach
2021, World NeurosurgeryCitation Excerpt :Then the endoscope was placed into the working cannula, and the ligamentum flavum was resected piece-by-piece using a punch under direct visualization. Laminotomy or medial facetectomy may be necessary in some cases because the L4-L5 interlaminar window is narrower than L5S1.7 Following, epidural fat, nerve root, and dural sac were exposed.
Advantages of a Microsurgical Translaminar Approach (Keyhole Laminotomy) for Upper Lumbar Disc Herniation
2018, World NeurosurgeryCitation Excerpt :During microsurgical discectomy, the classic surgical technique (i.e., interlaminar approach) for bone work is partial hemilaminectomy with or without medial facetectomy from the inferior edge of the lamina (spinolaminar junction), although the extent of laminectomy required depends on target fragment location and disc level. In the anatomic structure of the lumbar spine, the intervertebral disc space level moves higher away from the interlaminar space, and the isthmus width becomes narrower from the caudal to cranial segment.1,2 In other words, in the upper lumbar spine (L1-2 or L2-3), the disc space level is far from the inferior edge of the lamina, and the isthmus of the lamina is narrow.
The morphology and clinical significance of the intraforaminal ligaments at the L5–S1 levels
2016, Spine JournalCitation Excerpt :However, the fifth lumbar IVF is located in a region of structural and functional transition, and the transverse process of L5–S1 is very narrow. Some patients have a high iliac crest or an L5–S1 IVF puncture angle to the IVF that is too large for a transforaminal approach to be used [16–19]. Clinical treatment of L5–S1 disc herniation in these patients becomes very difficult.
The strategy and early clinical outcome of full-endoscopic L5/S1 discectomy through interlaminar approach
2015, Clinical Neurology and NeurosurgeryCitation Excerpt :Meanwhile, according to the anatomy study, the distance between S1 vertebral plate edge and the S1 vertebral endplate is relatively constant, with an average of about 13.9 mm. But on the other hand, the distance between the edge of L5 vertebral plate and L5 vertebral endplate varies from 3.0 mm to 8.5 mm [8]. Compared with the upper lumbar vertebral plate gap, L5/S1 vertebral plate gap is very big, with an average of 31 mm (21–40 mm).
The relation between the lumbar vertebrae and the spinal nerves for far lateral lumbar spinal approaches
2008, Journal of Clinical Neuroscience