Magnetic Resonance Imaging Study of Oblique Corridor and Trajectory to L1–L5 Intervertebral Disks in Lateral Position

Huang, Chunneng; Li, Fangcai; Tao, Yiqing

doi:10.1016/j.wneu.2019.10.147

Cited by 7 publications

(12 citation statements)

References 42 publications

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“…Our findings are similar to other studies based on different populations. Our results confirmed that the L4-L5 level has the narrowest entry point to anterior vessel distance in Hispanics, suggesting that ethnicity is not a determinant in the entry point to anterior vessel measure [7][8][9][10][11][12][13][14][15][16][17].…”

Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

“…To make the procedure as safe as possible, several image-based and cadaveric dissection studies have intensively examined the surgical ATP corridor [7][8][9][10][11][12][13][14][15][16][17]. Most of these publications are based on Asian [8][9][10][11][12][13][14]16] and American [7,15,17] populations. Therefore, while the general considerations have been well described (e.g., the anatomical elements involved in the oblique surgical corridor and the elements surrounding the lumbar spine at each level), data on the North American/ American Hispanic population are lacking.…”

Section: Discussionmentioning

confidence: 99%

“…Variations in the location of these structures can obstruct or modify the surgical corridor to reach the disc, thereby increasing the risk of fatal intraoperative vascular complications [8]. Therefore, anatomical research based on different imaging modalities and cadaveric studies has detailed the features of the left-sided ATP oblique corridor and the surrounding spinal retroperitoneal structures [7][8][9][10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Oblique Lateral Lumbar Interbody Fusion at L2-L5: Proposal of a New CT-based Preoperative Assessment to Minimize Risks

Quillo-Olvera

Kim

Quillo-Olvera

et al. 2022

J Minim Invasive Spine Surg Tech

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Objective: Oblique anterior to psoas (ATP) lumbar fusion is associated with advantages such as sufficient indirect decompression and restoration of lordosis. However, the ATP approach risks damaging the vascular elements anterior to the spine, and it requires a complicated left oblique surgical corridor that puts the contralateral neural elements at risk. Therefore, a thorough preoperative assessment of the location of entry into the disc space, a feasible trajectory to complete the intervertebral space procedure, and the possible retraction of the psoas muscle under these conditions are considered in this article.Methods: From January 2019 to January 2020, 160 lumbar CT scans were evaluated. Only 124 images from the L2-L3, L3-L4, and L4-L5 levels met the inclusion criteria. The length of the anterior vertebral line (AVL) and the middle-third of the disc in the anteroposterior axis were measured to localize the entry point (EP). The distance between the anterior arterial vessel (AV) and the EP was also measured. The trajectory commonly used to set the surgical instruments into the disc space was called α, and a new proposed trajectory termed β was calculated. The psoas cross-sectional area anterior to the β angle trajectory was measured to determine any possible retraction using this parameter. Results: The AVL-EP distances were L2-L3 11.49±0.89 mm, L3-L4 11.54±0.88 mm, and L4-L5 11.57±0.87 mm. The AV-EP lengths were 17.64±5.62 mm, 19.36±5.49 mm, and 16.48±6.47 mm at L2-L3, L3-L4, and L4-L5, respectively. The average α and β trajectory angles reported were 39.91º and 14.48º, respectively. Psoas muscle retraction was primarily noted at the L4-L5 level. Conclusion: This article’s proposed parameters represent a routine preoperative safety assessment in patients previously selected for oblique ATP lumbar fusion.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Oblique Lateral Lumbar Interbody Fusion at L2-L5: Proposal of a New CT-based Preoperative Assessment to Minimize Risks

Quillo-Olvera

Kim

Quillo-Olvera

et al. 2022

J Minim Invasive Spine Surg Tech

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“…The average distances of the levels above the L4 vertebra were more than 12.7 mm (increasing according to the highest level) on the left side, 8.92 mm in the L4/L5 intervertebral space, being considerably less on the right side at all levels (right intervertebral space L4/L5 of 1.46mm), so the approach from the right side is not recommended. At the same time, Ng et al 11 in Singapore, 2020, found a mean left L4/L5 OC measured in MRI of 12.1 mm, and Tao et al 25 in China, 2019, conducted another study in MRI but with patients in lateral decubitus, found a mean OC of 10.36 mm for the L4/L5 level. Molinares et al 1 in the USA also obtained a lower mean OC at L4/L5 (10.28 mm).…”

Section: Oblique Corridor L4/l5mentioning

confidence: 95%

Left Oblique Corridor for Pre-Psoas Approach: Image Study

Laos¹,

Urquizo²

2023

Coluna/Columna

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Introduction: This study describes the imaging characteristics and accessibility of the L4 / L5 left oblique corridor used in the OLIF spinal fusion approach and the dimensions of the left oblique corridor at L2/L3 and L3/L4. Methods: Observational, retrospective, and descriptive study, in which MRI is described for 330 patients. The length of the left OC L2/L3, L3/L4, and L4/L5 were measured and classified into four grades: 0 (not measurable), 1 (≤10 mm), 2 (10–20 mm), and 3 (≥20 mm). The psoas was measured at the level of the L4 / L5, and the modified Moro classification was used for the height of the psoas, considering high psoas from AII to AIV. The data was processed in the SPSS 26.0 system. Results: The mean age was 62.1 ± 13.5 years, the OC length in L2/L3, L3/L4 y L4/L5 were 16.1 ± 5.9, 16.2 ± 6.7 and 14.7 ± 8.8 mm, respectively. 14.8% had high psoas. OC grade 0 (2.1%) was obtained in 7 patients, 87 with grade 1 (26.4%), 129 with grade 2 (39.1%), and 107 with grade 3 (32.4%). The length of the OC in males was 2.4 mm (MD, 95% CI: 0.4–4.5, p: 0.02), more than in females. Conclusion: It was shown that 85.2% had an accessible psoas muscle for the left OLIF L4 / L5 approach, 71.5% had an accessible oblique corridor, and only 14.8% had high psoas. These parameters combined, 61.5% of MRI, were appropriate for this approach. Level of evidence III; Retrospective study.

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A novel surgical approach using the “lateral corridor” for minimally invasive oblique lumbar interbody fusion at L5-S1: a clinical series and technical note

Jang,

Lee,

Choi

et al. 2024

Eur Spine J

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Magnetic Resonance Imaging Study of Oblique Corridor and Trajectory to L1–L5 Intervertebral Disks in Lateral Position

Cited by 7 publications

References 42 publications

Oblique Lateral Lumbar Interbody Fusion at L2-L5: Proposal of a New CT-based Preoperative Assessment to Minimize Risks

Oblique Lateral Lumbar Interbody Fusion at L2-L5: Proposal of a New CT-based Preoperative Assessment to Minimize Risks

Left Oblique Corridor for Pre-Psoas Approach: Image Study

A novel surgical approach using the “lateral corridor” for minimally invasive oblique lumbar interbody fusion at L5-S1: a clinical series and technical note

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