CT-based analysis of oblique lateral interbody fusion from L1 to L5: location of incision, feasibility of safe corridor approach, and influencing factors

Razzouk, Jacob; Ramos, Omar; Mehta, Sachin; Harianja, Gideon; Wycliffe, Nathaniel; Danisa, Olumide; Cheng, Wayne K.

doi:10.1007/s00586-023-07555-1

Cited by 7 publications

(5 citation statements)

References 25 publications

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“…Molinares et al [ 14 ] discovered an adequate surgical corridor of access to the L4–5 discs in up to 91% of the studied MR images. Razzouk et al [ 23 ] measured the corridor at the L4–5 level and observed corridors less than 10 mm in 18% of the studied sample. Several authors suggested that the surgeon should consider alternative fusion techniques in less than 10 mm of the oblique corridor [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

An Expanded Surgical Corridor of Oblique Lateral Interbody Fusion at L4–5: A Magnetic Resonance Imaging Study

Limthongkul,

Praisarnti,

Tanasansomboon

et al. 2023

Neurospine

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Objective: We introduced a new preoperative method, the “expanded surgical corridor,” to evaluate the actual safety corridor, which may expand the possibility of performing oblique lateral interbody fusion (OLIF).Methods: Axial T2-weighted magnetic resonance images at the L4–5 disc level of 511 lumbar degenerative disease patients was evaluated. The distance between the medial edge of the left-sided psoas muscle and the major artery was measured as the conventional surgical corridor (CSc). The distance between the major vein and lumbar plexus was measured as the expanded surgical corridor (ESc).Results: The mean CSc and ESc were 13.9 ± 8.20 and 37.43 ± 10.1 mm, respectively. No surgical corridor was found in 7.05% of CSc and 1.76% of ESc, small corridor ( ≤ 1 cm) was found in 27.40% of CSc and 0.59% of ESc, moderate corridor (1–2 cm) was found in 42.07% of CSc and 1.96% of ESc, and large corridor ( > 2 cm) was found in 23.48% of CSc and 95.69% of ESc. A total of 33.83% (45 of 133) of whom were preoperatively categorized as having a limited surgical corridor by conventional measurement, underwent OLIF L4–5 successfully.Conclusion: By using the ESc, only 2.35% were categorized as having a limited surgical corridor. The other 97.65% of the patients had an approachable corridor that could be successfully operated by experienced spine surgeons who employ meticulous surgical dissection and thorough understanding of the anatomical structures. The ESc may represent true accessibility to the disc space for OLIF, particularly at the L4–5 level.

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Section: Discussionmentioning

confidence: 99%

An Expanded Surgical Corridor of Oblique Lateral Interbody Fusion at L4–5: A Magnetic Resonance Imaging Study

Limthongkul,

Praisarnti,

Tanasansomboon

et al. 2023

Neurospine

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“…Levene homogeneity of variance test and regression residual plots were used to assess homoscedasticity. 11 Kolmogorov-Smirnov tests and Q-Q plots were used to assess normality of data distribution. 12 Descriptive statistics comprised mean ± standard deviation, 95% confidence intervals, and minimum and maximum values.…”

Section: Methodsmentioning

confidence: 99%

Evolving Effects of the COVID-19 Pandemic on Hip Fracture Outcomes: A Retrospective Comparison of Pre, Early, and Late Pandemic Timepoints

Case,

Kricfalusi,

Ruckle

et al. 2024

JAAOS Glob Res Rev

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Introduction: Hospital systems were strained during the COVID-19 pandemic, and although previous studies have shown that surgical outcomes in healthy hip fracture patients were unaffected in the initial months of the pandemic, subsequent data are limited. This study examined the evolution of hip fracture care throughout the COVID-19 pandemic. Methods: A retrospective review (level III evidence) was done of surgically treated adult hip fractures at a Level 1 academic trauma center from January 2019 to September 2022, stratified into three groups: pre, early, and late pandemic. Continuous variables were evaluated with the Student t-test and one-way analysis of variance, categorical variables were evaluated with chi-squared, P < 0.05 considered significant. Results: Late pandemic patients remained in the hospital 30.1 hours longer than early pandemic patients and 35.7 hours longer than prepandemic patients (P = 0.03). High-energy fractures decreased in the early pandemic, then increased in late pandemic (P < 0.01). Early pandemic patients experienced more myocardial infarctions (P < 0.01). No significant differences in time to surgery, revision surgery, 90-day mortality, or other adverse events were noted. Conclusion: To our knowledge, this is the longest study evaluating hip fracture outcomes throughout the COVID-19 pandemic. These results are indicative of an overburdened regional health system less capable of facilitating patient disposition.

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“…SPSS version 28 (IBM Corporation, 2021, Armonk, NY) was utilized for all subsequent statistical analyses with alpha defined as P <0.05. Kolmogorov-Smirnov tests and Q-Q plots were used to assess data normality and Levene homogeneity of variance test and regression residual plots were used to evaluate homoscedasticity 14–16 . Correlation coefficients were categorized as weak, moderate, and strong corresponding to value ranges of 0 to 0.4, 0.4 to 0.7, and 0.7 to 1, respectively 17–19 .…”

Section: Methodsmentioning

confidence: 99%

“…Kolmogorov-Smirnov tests and Q-Q plots were used to assess data normality and Levene homogeneity of variance test and regression residual plots were used to evaluate homoscedasticity. [14][15][16] Correlation coefficients were categorized as weak, moderate, and strong corresponding to value ranges of 0 to 0.4, 0.4 to 0.7, and 0.7 to 1, respectively. [17][18][19] Paired sample t tests were used to assess for statistically significant differences among PFR, CT, and MRI-derived neuroforaminal measurements.…”

Section: Statistical Analysesmentioning

confidence: 99%

Normative Measurements of L1 to S1 Neuroforaminal Dimensions Derived From Plain Film Radiography, Computed Tomography, and Magnetic Resonance Imaging

Razzouk,

Vyhmeister,

Carter

et al. 2023

Spine

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Study Design. retrospective cohort Objective. To report normative measurements of L1-S1 lumbar neuroforamina on plain film radiography (PFR), computed tomography (CT), and magnetic resonance imaging (MRI), accounting for patient sex and ethnicity. Summary of Background Data. Quantitative criteria for diagnosis of neuroforaminal stenosis (NFS) remains unknown. Acquiring a thorough understanding of normative foraminal dimensions is a key step in formulating objective parameters for NFS. Methods. We measured 988 images from 494 patients between 18 and 35 years-old without spinal pathology who received PFR, CT, or MRI within one year of each other. Neuroforaminal measurements were defined as the height, area, and sagittal and axial widths. Statistical analyses were performed to assess relationships among PFR-, CT-, and MRI-derived neuroforaminal measurements as well as the influence of patient sex and ethnicity. Results. 330 PFR, 377 CT, and 281 MRI were measured. Of these, 213 PFR and CT, 117 PFR and MRI, and 164 MRI and CT intrapatient images were compared. Statistically significant differences were observed among PFR, CT, and MRI measurements across all levels L1-S1. PFR measurements were larger compared to those derived from CT and MRI. Weak-to-moderate correlations were observed between PFR and CT, PFR and MRI, and CT and MRI, with the magnitude of correlation decreasing caudally from L1-S1. Variations in neuroforaminal anatomy were observed based on sex and ethnicity. Conclusion. This study reports 25,951 measurements of normal L1-S1 neuroforaminal anatomy assessed by PFR, CT, and MRI. The values reported in this study may be used as normative reference measurements of the lumbar neuroforamina. PFR measurements of the neuroforamina are larger compared to those derived from CT and MRI across all levels from L1-S1. There is poor correlation among PFR, CT and MRI when measuring the lumbar neuroforamina. Differences in neuroforaminal anatomy are evident based on patient sex and ethnicity.

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CT-based analysis of oblique lateral interbody fusion from L1 to L5: location of incision, feasibility of safe corridor approach, and influencing factors

Cited by 7 publications

References 25 publications

An Expanded Surgical Corridor of Oblique Lateral Interbody Fusion at L4–5: A Magnetic Resonance Imaging Study

An Expanded Surgical Corridor of Oblique Lateral Interbody Fusion at L4–5: A Magnetic Resonance Imaging Study

Evolving Effects of the COVID-19 Pandemic on Hip Fracture Outcomes: A Retrospective Comparison of Pre, Early, and Late Pandemic Timepoints

Normative Measurements of L1 to S1 Neuroforaminal Dimensions Derived From Plain Film Radiography, Computed Tomography, and Magnetic Resonance Imaging

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