Kambin’s Triangle or Prism

There is confusion regarding the borders of Kambin’s triangle across the literature.

Kambin originally described the borders of this triangular working zone as:

  1. Anterior: Exiting nerve root
  2. Inferior: Proximal end plate of lower lumbar vertebra
  3. Posterior: Superior articular process of lower vertebra
  4. Medial: Traversing nerve root and dural sac

Though it was named as a “triangle” it was described with 4 borders with 2 triangles (in AP view and Lateral view) which gives a 3D structure more appropriately a “prism”.

Kambin's triangle AP view
Biswas, Rajasree & Choudhury, Arpita & Bhattacharya, Dipasri & Nandy, Sabyasachi. (2021). A comparative evaluation of kambinโ€™s triangle approach versus safe triangle approach for lumbar transforaminal epidural injection in patients with lumbar radiculopathy – A prospective, randomized, double blind study. Asian Journal of Medical Sciences. 12. 41-47. 10.3126/ajms.v12i8.36339. [CC BY 4.0]
Kambin's triangle lateral view
Waguia R, Gupta N, Gamel KL, Ukachukwu A. Current and Future Applications of the Kambin’s Triangle in Lumbar Spine Surgery. Cureus. 2022 Jun 6;14(6):e25686. doi: 10.7759/cureus.25686. PMID: 35812644; PMCID: PMC9259071. [CC BY 3.0]

Uses of Kambin’s triangle:

Kambin’s triangle is regarded as a “safe” space because it is devoid of important neurovascular structures. It is an anatomical corridor useful in:

  1. Transforaminal Epidural Steroid Injection (TFESI)
  2. Diagnostic discograms
  3. Access disc space in Transforaminal Lumbar Interbody Fusion (TLIF)
  4. Access disc space in Percutaneous Endoscopic Lumbar Discectomy (PELD)

Reference: Kambinโ€™s triangle: definition and new classification schema in: Journal of Neurosurgery: Spine Volume 32 Issue 3 (2019) Journals


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