Anatomy study for lumbar intertransverse approach

Objectives: To measure lumbar intertransverse structure and its adjacent elements,and to provide the reference for endoscopic intertranverse lumbar interbody fusion(ILIF).Methods: 10 fresh adult corpses were used to observe and measure the anatomy structure of lumbar intertransverse including nerve roots,blood vessels and the adjacent elements.The length of intertranverse ligament,length and width of bone textile fiber hole,the distance from TAP to the nervi spinales(TA),the distance from TAP to the dorsal branch neurovascular bundles(TB),the vertical distance from TAP to the center of intervertebral disc(TC) were determined,taking the point of superior articular process and transverse process(TAP) as the center,which were used to provide accurate anatomical marker for ILIF operation.Results: 80%(60/75) lumbar artery anterior branches and venas located in the ventral side of intertranverse ligament,and attached on inferior margin of upper transverse processes.The dorsal branch neurovascular bundles sent out branches behind the bone textile fiber hole.The length of intertranverse ligament,the length and width of bone textile fiber hole,TA,TB and TC was 21.9±2.2-23.1±2.2mm,4.2±1.0-5.1±0.8mm,3.7±0.2-4.0±0.7mm,8.0±2.5-14.6±2.5mm,2.9±1.1-4.5±1.2mm and 0.9±2.3-4.2±0.9mm respectively.Conclusions: Centered as lumbar TAP,between superior neurovascular bundle and lareral nervi spinales,there exists a triangle region,which can be used as the safe window for ILIF surgery due to its constant presence of TAP and the bone textile fiber hole.