A modified four-zone classification of the posterior lumbar spinal canal: An anatomical study and clinical application in microchannel surgery
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Le résumé fourni par la source
This study introduces and evaluates a modified four-zone classification of the posterior lumbar spinal canal, assessing its anatomical basis and clinical utility in guiding microchannel surgery. Current minimally invasive lumbar procedures rely predominantly on fluoroscopic imaging of bony landmarks for localization, often neglecting the consistent anatomical boundaries provided by the ligamentum flavum for surgical orientation and trajectory planning. Anatomical measurements were performed on six fresh-frozen human cadaveric spines to define key parameters of the ligamentum flavum and their spatial relationships with adjacent structures. A retrospective clinical analysis compared 223 patients undergoing microchannel surgery: 103 patients in the conventional localization group (Group A) and 120 patients in the modified four-zone classification group (Group B). Outcomes assessed included fluoroscopy time, microchannel tilt angle, estimated blood loss, operative duration, length of hospital stay, VAS scores, ODI, and Modified MacNab criteria. Anatomically, the interligamentum flavum space measured 12.3 ± 1.8 mm on the left and 11.9 ± 1.9 mm on the right, with the S-point located approximately midway between the ligamentum flavum boundaries. Clinically, Group B demonstrated significant reductions in fluoroscopy time (4.4 ± 1.4 vs. 5.7 ± 1.7 min, p < 0.01), microchannel tilt angle (7.8 ± 2.7° vs. 10.1 ± 3.6°, p < 0.01), blood loss (44.7 ± 12.7 vs. 58.5 ± 13.5 ml, p < 0.01), operative time (69.4 ± 22.5 vs. 81.4 ± 27.1 min, p < 0.01), along with less early postoperative incision pain and length of hospital stay (p < 0.01). While long-term improvements in back pain VAS and ODI scores were similar between groups, Group B demonstrated superior outcomes in both leg pain VAS scores (final score: 0.5 ± 0.6 vs. 1.8 ± 0.8, p < 0.01) and patient satisfaction (Modified MacNab Excellent/Good rate: 85.8% vs. 75.7%, p = 0.03).The modified four-zone classification offers an anatomically reliable framework for posterior lumbar microchannel surgery, enabling precise anatomical targeting, reducing radiation exposure, and improving both perioperative and long-term functional outcomes, This approach may facilitate the standardization and enhancement of procedural precision.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- A modified four-zone classification of the posterior lumbar spinal canal: An anatomical study and clinical application in microchannel surgery
- Date Crossref
- 13/05/2026
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Taizhou Fourth People's Hospital Department of Neurosurgery pays non établi dans la noticeÉtablissement de santé
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Nantong University pays non établi dans la noticeUniversité ou école supérieure
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Yancheng First People's Hospital pays non établi dans la noticeÉtablissement de santé
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Mudanjiang Medical University Department of Anatomy pays non établi dans la noticeUniversité ou école supérieure
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Fujian University of Traditional Chinese Medicine pays non établi dans la noticeUniversité ou école supérieure
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Soochow University Department of Neurosurgery pays non établi dans la noticeUniversité ou école supérieure
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Second Affiliated Hospital of Soochow University pays non établi dans la noticeÉtablissement de santé
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Department of Neurosurgery pays non établi dans la noticeInstitution
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Jingjiang Chinese Medicine Hospital Department of Orthopedics pays non établi dans la noticeÉtablissement de santé
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Affiliated Hospital of Nanjing University Medical School Yancheng First Hospital pays non établi dans la noticeUniversité ou école supérieure
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The Second Affiliated Hospital of of Fujian Traditional Chinese Medicine University Department of Neurosurgery pays non établi dans la noticeUniversité ou école supérieure
Department of Neurosurgery — Taizhou Fourth People's Hospital, Nantong University et Yancheng First People's Hospital, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.