Study on anatomy and clinical application of Kambin's triangle and modified quadrangle

Objective: We through the anatomy of cadavers to study the " Kambin's triangle " in the safe working area of lumbar intervertebral foramen and to provide anatomical reference for clinical lumbar fusion through Kambin's triangle approach. Methods: five complete cadaveric specimens were taken, the soft tissue of the lumbar back was removed, the transverse process, upper and lower articular processes and part of the vertebral lamina were bitten, the Kambin's triangle area of the lumbar spine was completely exposed, the bottom edge and height of the Kambin's triangle were measured, and the area of the Kambin's triangle was calculated; Using Kirschner wire, pull and fix the traveling nerve root to make the Kambin's triangle into a rectangle, measure the length of the bottom edge and height again, calculate the area, and compare the two groups of data. Results: the average height of the Kambin's triangle was 11.20mm ± 2.10mm, and the average height of the improved four corners was 11.19mm ± 1.93mm. The height of the improved four corners was slightly shorter than that of the Kambin's triangle. There was a significant correlation between the two, but the difference was not statistically significant. The average bottom of Kambin's triangle is 10.78mm ± 1.95mm, and the average bottom of improved four corners is 12.14mm ± 1.78mm. The length of the bottom edge of improved four corners is greater than that of Kambin's triangle. There is a significant correlation between them, and the difference is statistically significant; The average area of Kambin's triangle is 61.79mm2 ± 20.71mm2, and the area of improved four corners is 137.71mm2 ± 38.20mm2. The area of improved four corners is significantly larger than that of Kambin's triangle. There is a significant correlation between the two, and the difference is statistically significant. Conclusion: there is a narrow right angle triangle area surrounded by traveling nerve root, dural sac and superior endplate of lower vertebral body in the lumbar intervertebral foramen. If the traveling nerve root is pulled and fixed to turn the traditional Kambin's triangle into a quadrilateral, the bottom edge of the Kambin's triangle area can be significantly longer and the area can be significantly expanded, which can be operated more safely.