[Transperitoneal laparoscopic approach to the L5-S1 disk. Value of computed x-ray tomography].
OBJECTIVE
The aim of this study was to determine the laparoscopic approach of L5-S1 disk, by preoperative C.T. evaluation.


METHODS
30 patients justified tomodensitometry for low back pain or sciatalogy. We added two scan views and a lateral radiologic mode including pubis. We defined several parameters in order to evaluate the "useful" triangle limited by iliac veins and anterior edge of S1 plateau. This surface was divided in discal and vertebral surfaces. We studied also cutaneous projections of axis and usefull zones for discal or transcorporeal approach.


RESULTS
The "usefull" surface was about 6 cm2 (from 0 to 13.12 cm2). The average vertebral surface was 2.58 cm2 and 3.42 cm2 for discal surface. The best cutaneous point for introduction was 3.3 cm from ombilic in transcorporeal approach and 11.3 cm in discal approach.


CONCLUSIONS
Peroperative C.T. evaluation seems to be more usefull than radiological for preoperative planning. Peroperative radiographical control is not always efficient to prevent foraminal radicular risk.
Norotte
G
G
Service de chirurgie orthopédique et traumatologique, Centre Hospitalier Général, Gap.
Aimard
P
P
Champey
J C
JC
Panel
N
N
D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000601:surgery*; D010535:Laparoscopy; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000601:surgery; D008159:Lumbar Vertebrae; D008433:Mathematics; D012447:Sacrum; D012585:Sciatica / Q000000981:diagnostic imaging / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods*; D014057:Tomography, X-Ray Computed
Abords du disque L5-S1 par coelioscopie trans-péritonéale, Intérêt d'une étude tomodensitométrique préalable.