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Transforaminal endoscopic approach to L5S1: imaging characterization of the lower lumbar spine and pelvis for surgical planning

dc.contributor.authorSousa, José Miguel
dc.contributor.authorSerrano, António
dc.contributor.authorNave, Afonso
dc.contributor.authorMascarenhas, Vasco
dc.contributor.authorNogueira, Paulo Jorge
dc.contributor.authorGamelas, Joao
dc.contributor.authorGuimarães Consciência, José
dc.date.accessioned2023-07-18T12:56:20Z
dc.date.available2023-07-18T12:56:20Z
dc.date.issued2023
dc.description© 2023 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).pt_PT
dc.description.abstractObjective: To determine and compare pelvic and lumbosacral reference parameters with computed tomography in patients with low back pain (LBP) and a control group of asymptomatic patients to provide quantification data and morphological correlations for L5S1 transforaminal endoscopic approach (L5S1TEA). Methods: We prospectively evaluated 100 patients with LBP and a control group of 100 individuals, with spinopelvic computed tomography. We measured lumbopelvic and L5S1 transforaminal approach parameters: maximum approach angle (maxAA) and minimum approach angle (minAA) and skin incision (maxSI and minSI), iliac crest (IC) projection at intersection point (ICPi), distance between the projected intersection of maxAA with the ilium (ICi) and the posterior limit of the IC (ΔICi-ICpost), and distance between ICi and spinous process (ΔICi-SP). Results: Females and ICPi were increased in the LBP group: maxAA: 48.38° ± 5.09°; minAA:32.5° ± 3.90°; maxSI: 11.39 ± 1.86 cm; and minSI: 8.30 ± 1.48 cm. Ilium intersection was increased in males; IC projection at the highest point (ICPh) was higher than ICPi; maxAA intersected the ilium in 28% and minAA in 1.5% of cases; ICi was positively correlated with facet angle, ICPh, and ICPi and negatively with ΔICi-SP. Conclusions: Our results set preliminary reference values for L5S1TEA surgical planning. Besides higher ICPi, there were no differences between groups in measured parameters. Traditional IC height (ICPh) does not correspond to the point of intersection of the approach and is significantly higher than ICPi. ICi correlated to higher facet angle values, ICPh and ICPi grades, and lower ΔICi-SP. Potential conflict with the ilium is increased in the male population. IC is not impeditive of L5S1TEA in most cases.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationWorld Neurosurg. 2023 Jul;175:e809-e817pt_PT
dc.identifier.doi10.1016/j.wneu.2023.04.026pt_PT
dc.identifier.eissn1878-8769
dc.identifier.issn1878-8750
dc.identifier.urihttp://hdl.handle.net/10451/58653
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/world-neurosurgerypt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectEndoscopypt_PT
dc.subjectHigh iliac crestpt_PT
dc.subjectL5S1pt_PT
dc.subjectReference valuept_PT
dc.subjectTransforaminalpt_PT
dc.titleTransforaminal endoscopic approach to L5S1: imaging characterization of the lower lumbar spine and pelvis for surgical planningpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPagee817pt_PT
oaire.citation.startPagee809pt_PT
oaire.citation.titleWorld Neurosurgerypt_PT
oaire.citation.volume175pt_PT
person.familyNameSousa
person.familyNameNogueira
person.givenNameJosé Miguel
person.givenNamePaulo Jorge
person.identifier1013768
person.identifier.ciencia-id2410-2DCC-F213
person.identifier.orcid0000-0002-1790-8213
person.identifier.orcid0000-0001-8316-5035
person.identifier.ridQ-7802-2016
person.identifier.ridAAR-5605-2020
person.identifier.scopus-author-id7005428250
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication54d4d329-1d3e-410d-b4da-66d66b016713
relation.isAuthorOfPublication9d24d0e5-5fab-4fef-b962-b0333e28f9d1
relation.isAuthorOfPublication.latestForDiscovery54d4d329-1d3e-410d-b4da-66d66b016713

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