METHODS: A cross-sectional analysis involving 102 MRIs that met the inclusion criteria was obtained and analyzed at the L3/L4, L4/L5, and L5/S1 discs level. For each level, the Kambin triangle was measured. By evaluating those measurements, the viability of this method was determined.
RESULTS: Safe working zone approach angles were consistently getting wider from L3 to S1 levels. It was statistically significant to be wider for the left side for the mean angle of lateral nucleus trajectory at the L4/L5 level and L5/S1. The entry point is at 32, 45, and 55-60 mm from the midline, and the instrument should be directed at 12°, 20°, and 27° medially for the lateral nucleus at L3/L4, L4/L5, and L5/S1, respectively. The center of the nucleus pulposus entry point is at 64, 77, and 85 mm from the midline with a medial inclination of 40°, 47°, and 52°, respectively, for L3/L4, L4/L5, and L5/S1. For the posterior nucleus pulposus, the skin should be pierced 90, 140, and 180 mm from the midline and directed medially at 53°, 61°, and 68°, respectively, for L3/L4, L4/L5, and L5/S1. The posterior annulus fibrosis entry point is 172, 355, and 450 mm with a medial inclination of 69°, 80°, and 84° at L3/L4, L4/L5, and L5/S1, respectively. The sagittal inclination is 3° cephalad at L3/L4, 10° caudally at L4/L5, and 27° caudally at L5/S1.
CONCLUSIONS: Preoperative MRI assessment is important to determine the angle of trajectory for the safe entry point for intradiscal procedure via transforaminal approach.
METHOD: Underpinned by the self-efficacy theory, we argue that high-quality safety leadership enhances nurses' safety knowledge and motivation and subsequently, improves their safety behavior (safety compliance and safety participation). A total of 332 questionnaire responses were gathered and analyzed using SmartPLS Version 3.2.9, revealing the direct effect of safety leadership on both safety knowledge and safety motivation.
RESULTS: Safety knowledge and safety motivation were found to directly and significantly predict nurses' safety behavior. Notably, safety knowledge and safety motivation were established as important mediators in the relationship between safety leadership and nurses' safety compliance and participation.
PRACTICAL APPLICATIONS: The findings of this study offer key guidance for safety researchers and hospital practitioners in identifying mechanisms to enhance safety behavior among nurses.