Turkish Neurosurgery
ANATOMIC FEATURES OF NEURAL FORAMEN AT T12-L1 LEVEL FOR ENDOSCOPIC TRANSFORAMINAL APPROACH TO PARAMEDIAN AND FORAMINAL DISC HERNIATIONS: AN ANATOMIC STUDY ON FRESH HUMAN CADAVERS
Halil CAN1, Cengiz GOMLEKSIZ2, Furkan DIREN3, Erdinc CIVELEK3, Atilla KIRCELLI4, Aydin AYDOSELI5, Altay SENCER5
1Medicine Hospital, Neurosurgery Clinic, istanbul,
2Private Kolan International Hospital, Neurosurgery Clinic, istanbul,
3GOP Taksim Training and Research Hospital, Department of Neurosurgery, istanbul,
4Erasmus MC, Department of Neurosurgery, istanbul,
5Istanbul University, Istanbul School of Medicine, Department of Neurosurgery, istanbul,
DOI: 10.5137/1019-5149.JTN.26646-19.4

Aim:Our present cadaveric study was designed to explore the anatomic features of the neural foramen in particularly at the T12-L1 level in order to assess reveal the safety and efficiency of the endoscopic transforaminal approach for paramedian and foraminal disc herniations at this level. Material and Methods:The study included 15 fresh human cadavers were studied. The soft tissues were removed at the T12-L1 level and bony tissues were exposed including the transverse processes. The anatomical structures constituting the triangular safe working zone (TSWZ) were explored. The nerve root length, nerve root width, nerve root angle, TSWZ height, and base of TSWZ base, nerve root width, nerve root angle and disc height were recorded.Results:The root length is the hypotenuse of the TSWZ between the axilla of the exiting root and the lateral margin of the pedicle, and the mean root length was 14.94±2.45 mm. The dural height is the interval between the axilla of the exiting nerve root axilla and the superior end plate of the caudal vertebra, and the mean of the dural height was 10.95±1.74 mm. The Base of TSWZ is the distance between the lateral margin of the dural sac and the medial margin of the exiting root, and the mean measurement for the base measurement was 11.83±2.26 mm. Conclusion:According to the results, we believe that Kambin’s triangular working zone is a safe area to consider for the endoscopic transforaminal approach at the T12-L1 level. Key Words: T12-L1 level, endoscopic transforaminal approach, triangular safe working zone

Corresponding author : Halil CAN