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How dimensions can guide surgical planning and training: a systematic review of Kambin's triangle.
Waguia Kouam, Romaric; Tabarestani, Troy Q; Sykes, David A W; Gupta, Nithin; Futch, Brittany G; Kakmou, Elisabeth; Goodwin, C Rory; Foster, Norah A; Than, Khoi D; Wiggins, Walter F; Abd-El-Barr, Muhammad M.
Afiliación
  • Waguia Kouam R; 1Campbell University School of Osteopathic Medicine, Lillington.
  • Tabarestani TQ; 2Duke University School of Medicine, Durham.
  • Sykes DAW; 2Duke University School of Medicine, Durham.
  • Gupta N; 1Campbell University School of Osteopathic Medicine, Lillington.
  • Futch BG; 2Duke University School of Medicine, Durham.
  • Kakmou E; 3Department of Neurosurgery, Duke University Hospital, Durham, North Carolina.
  • Goodwin CR; 3Department of Neurosurgery, Duke University Hospital, Durham, North Carolina.
  • Foster NA; 4Department of Orthopedic Surgery, Miami Valley Hospital, Centerville, Ohio; and.
  • Than KD; 3Department of Neurosurgery, Duke University Hospital, Durham, North Carolina.
  • Wiggins WF; 5Department of Radiology, Duke University Hospital, Durham, North Carolina.
  • Abd-El-Barr MM; 3Department of Neurosurgery, Duke University Hospital, Durham, North Carolina.
Neurosurg Focus ; 54(1): E6, 2023 01.
Article en En | MEDLINE | ID: mdl-36587400
OBJECTIVE: The authors sought to analyze the current literature to determine dimensional trends across the lumbar levels of Kambin's triangle, clarify the role of imaging techniques for preoperative planning, and understand the effect of inclusion of the superior articular process (SAP). This compiled knowledge of the triangle is needed to perform successful procedures, reduce nerve root injuries, and help guide surgeons in training. METHODS: The authors performed a search of multiple databases using combinations of keywords: Kambin's triangle, size, measurement, safe triangle, and bony triangle. Articles were included if their main findings included measurement of Kambin's triangle. The PubMed, Scopus, Ovid, Cochrane, Embase, and Medline databases were systematically searched for English-language articles with no time frame restrictions through July 2022. RESULTS: Eight studies comprising 132 patients or cadavers were included in the study. The mean ± SD age was 66.69 ± 9.6 years, and 53% of patients were male. Overall, the size of Kambin's triangle increased in area moving down vertebral levels, with L5-S1 being the largest (133.59 ± 4.36 mm2). This trend followed a linear regression model when SAP was kept (p = 0.008) and removed (p = 0.003). There was also a considerable increase in the size of Kambin's triangle if the SAP was removed. CONCLUSIONS: Here, the authors have provided the first reported systematic review of the literature of Kambin's triangle, its measurements at each lumbar level, and key areas of debate related to the definition of the working safe zone. These findings indicate that CT is heavily utilized for imaging of the safe zone, the area of Kambin's triangle tends to increase caudally, and variation exists between patients. Future studies should focus on using advanced imaging techniques for preoperative planning and establishing guidelines for surgeons.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Radiculopatía / Cirujanos Tipo de estudio: Prognostic_studies / Systematic_reviews Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Neurosurg Focus Asunto de la revista: NEUROCIRURGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Radiculopatía / Cirujanos Tipo de estudio: Prognostic_studies / Systematic_reviews Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Neurosurg Focus Asunto de la revista: NEUROCIRURGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos