The hypotenuse is the exiting nerve; the base is the caudad vertebral body; and the height is the traversing nerve root. from publication: Kambin’s Triangle. To compare the short-term effect and advantage of transforaminal epidural steroid injection (TFESI) performed using the Kambin’s triangle and. Objective The aim of this study was to conduct a randomized, blinded, prospective outcome study on the short-term benefits of the Kambin triangle vs. the.

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Conflicts of interest There are no conflicts of interest. In a retrospective study, Murthy et al. Surgical morbidity has, therefore, limited the use of surgery as an early treatment option in disc degeneration and herniation.

Register Now or Log In. Gender, BMI, period of prevalence, age, targeted nerve root and diffusion of the contrast agent were compared between the two groups using the chi-square test, Fisher’s exact test, and Mann-Whitney U method.

The subjects of this study were patients who visited the Department of Rehabilitation Medicine for lumbar nerve root pain between July 1 and June 31 This method and technology is a further development of the original access technique.

All exiting nerves were protected in this safe zone and the thecal sac remained inviolate. Introduction Wolfgang Rauschning’s work illustrating the patho-anatomy of degenerative disc disease and degenerative conditions of the lumbar spine serves as a basis for treating pathologic findings with tissue-sparing, minimally invasive spine surgery.

Note the more cephalad the disc, the larger the foraminal portal. Many clinical reports have indicated that PELD is preferable to conventional open techniques.

They observed only In total, the contrast agent diffused into the anterior epidural space in 21 They recommended that the guide needle should be attached to the lateral aspect of the superior facet for the insertion of dilators and cannula before accessing the annulus. Results of surgical treatment of painful adult scoliosis.


Percutaneous lateral discectomy kambjn the lumber spine: B Lateral view of the lumbar spine, with the quadrant system superimposed. The beveled cannula can be positioned to view the epidural space, annular wall, nucleus pulposus, and intradiscal cavity in the same field of vision.

Paraplegia following a thoracolumbar transforaminal epidural steroid injection. This area is called “the safe triangle,” because the space mainly contains only the spinal nerve and vessels. References Publications referenced by this paper. Comparison of the numeric rating scale NRS between the two groups was conducted by repeated measures analysis of variance ANOVAand Bonferroni’s correction was applied post-hoc.

Subpedicular approach of the L5 nerve root. They did not describe about the type of anesthesia used during the surgery. Uniportal technique for selective endoscopic discectomy. Method Forty-two patients with radicular pain from lumbar spinal stenosis were enrolled.

Introduction – Part 1. The transforaminal approach is also used for foraminal disc herniation, while the posterolateral approach is used for extraforaminal lesions.

Spine, Apr 20, 33 9pp Pathoanatomy and pathophysiology of nerve root compression. Thus, epidural steroid injections for spinal stenosis had clinical effects, and the transforaminal approach, when compared to others, was effective in improving symptoms with smaller amount of agents, kkambin the agents could easily reach the targeted nerve root, dorsal root ganglion and the anterior of epidural space.

Approaches used in this area have several merits, including increased safety, such as protection of epidural and nervous system, prevention of venous congestion and chronic nervous edema and prevention of epidural bleeding kambjn scarring in tissues around the nerve and epidural. To compare the short-term effect and advantage of transforaminal epidural steroid injection TFESI performed using the Kambin’s triangle and subpedicular approaches.

Parviz Kambin was the first surgeon, who described the transforaminal endoscopic access to herniated discs. Minimally invasive surgical options that do not have the inherent approach-related morbidity are possible with the endoscopic lambin portal, therefore endoscopic diagnosis and surgical intervention can be considered for painful spinal conditions that were previously operated on only when there was evidence of nerve damage.


This line was drawn halfway between the farthest medial 2 and farthest lateral 3 points on the pedicle. Thus, in this study, the final target site of injection was determined to be the posterior inferior at the lateral view Fig.

The Kambin’s triangle approach maybe an alternative method for transforaminal epidural steroid injection in cases where needle tip positioning in the anterior epidural space is difficult.

Kambin Award

Preganglionic approach to transforaminal epidural steroid injections. Report of interim results. Ji Woong ParkM. Patients were placed in the prone position and were supported by pillows under the abdomen to reduce lumbar lordosis.

A prospective controlled clinical study. J Bone Joint Surg Am. Atlas of Minimal Access Surgery, 2nd Edition. Paraplegia after lumbosacral nerve root block: However, there was no significant difference between the friangle groups in initial pain, pain after 2 weeks and pain changes after 4 weeks Table 2.

This concept is widely accepted for not only PELD but also epidural injection and interbody fusion techniques. They suggested using a partial superior facetectomy to avoid ENR injury [Figure 2].

Anatomical relationship between Kambin’s triangle and exiting nerve root

It is defined as a right triangle over the dorsolateral disc. There it trizngle through the proximal portion of the dorsal root ganglion and the ventral root complex. InKambin introduced endoscopic intervertebral discectomy by posterolateral approach, defining the Kambin’s triangle as the site to approach the intervetebral disc.

Suggested causes include inflammatory changes around nerve root, venous congestion and hematogenous disability. Local corticosteroid application blocks transmission in normal nociceptive C-fibres.