• Paerhati Rexiti, Dilimulati Aikeremu, Shuiquan Wang, Nueraihemaiti Abuduwali, Alafate Kahaer, and Weibin Sheng.
• The First Affiliated Hospital of Xinjiang Medical University, Department of Spine Surgery - Ürümqi, China.
• Rev Assoc Med Bras (1992). 2022 Jan 1; 68 (6): 754-758.

ObjectiveTo reduce surgical exposure and improve accuracy, this study evaluated the anatomical distance parameter D (including D1, D2, and D3) of the lumbar isthmus for cortical bone screw insertion.MethodsA total of 25 structurally complete lumbar dry specimens were used for lumbar anatomy measurements. The six cadaver specimens were divided into upper and lower parts on the plane of the T11-T12 vertebrae, and we use the lower parts. Therefore, six lumbar wet specimens and another four complete lumbar dry specimens were selected. The lumbar isthmus tangent point was considered a coordinate origin, and the insertion point was determined through translating the distance of D1 value to the midline of the vertebral body horizontally and then vertically moved toward inferior board of the transverse process with the distance of D3 value.ResultsIn four dry and six wet intact lumbar specimens, cortical bone screws were placed according to the average value of the isthmus parameter D. A total of 100 trajectories were verified in specimens by X-ray and computed topography scan to evaluate the safety, accuracy, and feasibility of the surgical use of isthmus parameter D. Using this parameter, the rates of excellent screw placement were 95% (38/40) in four dry specimens and 88.7% (53/60) in six wet specimens.ConclusionThe isthmus parameter D is easier to use by the operator, which can improve surgical accuracy and reduce operation time.Level Of EvidenceLevel IV, prospective study.

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