BACKGROUND  The interlaminar window is the most important anatomical corridor during the posterior approach for lumbar and lumbosacral pathologies. Three-dimensional (3D) reconstruction of the L5-S1 interlaminar window including accurate measurements may be beneficial for the surgeon. The aim of this study was to measure relevant surgical parameters of the L5-S1 interlaminar window based on 3D reconstruction of lumbar computed tomography (CT). METHODS  Fifty thin-layer CT data were retrospectively collected, segmented, and reconstructed. Relevant surgical parameters included the width, left height, right height, interpedicular distance (IPD), area, and suitable approach area of the L5-S1 interlaminar window. Morphological measurements were performed independently by two experienced experts. Patients with disk herniation at L5-S1 were regarded as group A (n = 28) and those without L5-S1 disk herniation were regarded as group B (n = 22). RESULTS  The average left height, right height, width, and area of the L5-S1 interlaminar window were 9.14 ± 2.45 mm, 9.55 ± 2.46 mm, 23.55 ± 4.91 mm, and 144.57 ± 57.05 mm2, respectively. The average IPD at the superior, middle, and inferior pedicle levels was 29.29 ± 3.39, 27.96 ± 3.38, and 37.46 ± 4.23 mm, respectively, with significant differences among these three parameters (p < 0.05). The average suitable approach areas of the L5-S1 interlaminar window were the following: left axilla-24.52 ± 15.91 mm2; left shoulder-27.14 ± 15.48 mm2; right axilla-29.95 ± 17.17 mm2; and right shoulder-31.12 ± 16.40 mm2 (p > 0.05). There were no significant differences between groups A and B in these parameters (p > 0.05), except the inferior IPD (36.69 ± 3.73 vs. 39.23 ± 3.01 mm, p = 0.017 < 0.05). CONCLUSION  The morphological measurement of the L5-S1 interlaminar window based on 3D reconstruction provided accurate and reliable reference data for posterior microsurgical and endoscopic approaches as well as percutaneous infiltrations.

中文翻译：

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L5-S1 层间窗的手术相关形态参数：基于 CT 数据 3D 重建的统计分析。

背景技术在腰椎和腰骶部病变的后路手术过程中，层间窗是最重要的解剖通道。L5-S1 层间窗的三维 (3D) 重建（包括精确测量）可能对外科医生有益。本研究的目的是基于腰椎计算机断层扫描 (CT) 3D 重建来测量 L5-S1 层间窗的相关手术参数。方法回顾性收集50份薄层CT数据，并进行分割和重建。相关手术参数包括L5-S1层间窗的宽度、左高、右高、椎弓根间距离（IPD）、面积和合适的入路面积。形态学测量由两位经验丰富的专家独立进行。将有L5-S1椎间盘突出症的患者视为A组（n = 28），将无L5-S1椎间盘突出症的患者视为B组（n = 22）。结果 L5-S1层间窗平均左高、右高、宽度和面积分别为9.14±2.45 mm、9.55±2.46 mm、23.55±4.91 mm和144.57±57.05 mm2。上、中、下椎弓根水平的平均 IPD 分别为 29.29 ± 3.39、27.96 ± 3.38 和 37.46 ± 4.23 mm，这三个参数之间存在显着差异（p < 0.05）。L5-S1层间窗的平均合适入路面积如下：左腋窝-24.52±15.91mm2；左肩-27.14 ± 15.48 mm2；右腋窝-29.95 ± 17.17 mm2；右肩为 31.12 ± 16.40 mm2 (p > 0.05)。除了 IPD 较差（36.69 ± 3.73 vs. 39.23 ± 3.01 mm，p = 0.017 < 0.05）外，A 组和 B 组之间的这些参数没有显着差异（p > 0.05）。结论 基于3D重建的L5-S1层间窗形态学测量为后路显微手术、内镜入路以及经皮浸润提供了准确可靠的参考数据。