scholarly journals A psoas splitting approach developed for outpatient lateral interbody fusion versus a standard transpsoas approach

2018 ◽  
Vol 4 (2) ◽  
pp. 195-202 ◽  
Author(s):  
Kingsley R. Chin ◽  
Fabio J. R. Pencle ◽  
Morgan D. Brown ◽  
Jason A. Seale
Keyword(s):  
Interbody Fusion ◽  
Lateral Interbody Fusion ◽  
Transpsoas Approach ◽  
Lateral Interbody

An anatomical study of the lumbosacral plexus as related to the minimally invasive transpsoas approach to the lumbar spine

2009 ◽  
Vol 10 (2) ◽  
pp. 139-144 ◽  
Author(s):  
David M. Benglis ◽  
Steve Vanni ◽  
Allan D. Levi
Keyword(s):  
Lumbar Spine ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Psoas Muscle ◽  
Anatomical Study ◽  
Lumbosacral Plexus ◽  
Disc Space ◽  
Lateral Interbody Fusion ◽  
Transpsoas Approach ◽  
Lateral Interbody

Object Minimally invasive anterolateral approaches to the lumbar spine are options for the treatment of a number of adult degenerative spinal disorders. Nerve injuries during these surgeries, although rare, can be devastating complications. With an increasing number of spine surgeons utilizing minimal access retroperitoneal surgery to treat lumbar problems, the frequency of complications associated with this approach will likely increase. The authors sought to better understand the location of the lumbar contribution of the lumbosacral plexus relative to the disc spaces encountered when performing the minimally invasive transpsoas approach, also known as extreme lateral interbody fusion or direct lateral interbody fusion. Methods Three fresh cadavers were placed lateral, and a total of 3 dissections of the lumbar contribution of the lumbosacral plexus were performed. Radiopaque soldering wire was then laid along the anterior margin of the nerve fibers and the exiting femoral nerve. Markers were placed at the disc spaces and lateral fluoroscopy was used to measure the location of the lumbar plexus along each respective disc space in the lumbar spine (L1–2, L2–3, L3–4, and L4–5). Results The lumbosacral plexus was found lying within the substance of the psoas muscle between the junction of the transverse process and vertebral body and exited along the medial edge of the psoas distally. The lumbosacral plexus was most dorsally positioned at the posterior endplate of L1–2. A general trend of progressive ventral migration of the plexus on the disc space was noted at L2–3, L3–4, and L4–5. Average ratios were calculated at each level (location of the plexus from the dorsal endplate to total disc length) and were 0 (L1–2), 0.11 (L2–3), 0.18 (L3–4), and 0.28 (L4–5). Conclusions This anatomical study suggests that positioning the dilator and/or retractor in a posterior position of the disc space may result in nerve injury to the lumbosacral plexus, especially at the L4–5 level. The risk of injuring inherent nerve branches directed to the psoas muscle as well as injury to the genitofemoral nerve do still exist.

scholarly journals Minimally invasive lateral transpsoas approach for lumbar corpectomy and stabilization

2019 ◽  
Vol 10 ◽  
pp. 153
Author(s):  
Umesh Srikantha ◽  
Yadhu Kasetti Lokanath ◽  
Akshay Hari ◽  
S. Nirmala ◽  
Ravi Gopal Varma
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Compression Fracture ◽  
Early Mobilization ◽  
Tubular Retractor ◽  
Lateral Interbody Fusion ◽  
Transpsoas Approach ◽  
Lateral Interbody ◽  
Anterior Column Reconstruction ◽  
Lumbar Corpectomy

Background: Here, we present our experience with the minimally invasive (MI) transpsoas approach for lumbar corpectomy and stabilization. Transpsoas approach accesses the lumbar spine and includes both the direct lateral interbody fusion and extreme lateral interbody fusion techniques. Both procedures utilize a tubular retractor system which facilitates adequate retraction and direct visualization of the target, while supposedly reducing soft tissue trauma. Case Description: We evaluated two patients, one with a traumatic L2 wedge compression fracture and the other with an L3 pathological compression fracture due to multiple myeloma. Both patients underwent MI transpsoas lumbar corpectomy, anterior column reconstruction with an expandable cage, and posterior pedicle screw instrumentation to correct a kyphotic deformity. Both patients were mobilized on the 1st postoperative day and experienced significant postoperative pain relief. Conclusion: In two cases involving L2 and L3 compression fractures, MI transpsoas lumbar corpectomy was safely performed, with reduced perioperative and postoperative morbidity. Here, the transpsoas approach also allowed for early mobilization, adequate postoperative biomechanical stability, and resulted in immediate good outcomes.

scholarly journals Lateral Transpsoas Fusion: Indications and Outcomes

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Vishal C. Patel ◽  
Daniel K. Park ◽  
Harry N. Herkowitz
Keyword(s):  
Interbody Fusion ◽  
Motor Deficits ◽  
Low Grade ◽  
Disc Disease ◽  
Lateral Interbody Fusion ◽  
Transpsoas Approach ◽  
Lower Blood ◽  
Short And Long Term ◽  
Lateral Interbody

Spinal fusion historically has been used extensively, and, recently, the lateral transpsoas approach to the thoracic and lumbar spine has become an increasingly common method to achieve fusion. Recent literature on this approach has elucidated its advantage over more traditional anterior and posterior approaches, which include a smaller tissue dissection, potentially lower blood loss, no need for an access surgeon, and a shorter hospital stay. Indications for the procedure have now expanded to include degenerative disc disease, spinal stenosis, degenerative scoliosis, nonunion, trauma, infection, and low-grade spondylolisthesis. Lateral interbody fusion has a similar if not lower rate of complications compared to traditional anterior and posterior approaches to interbody fusion. However, lateral interbody fusion has unique complications that include transient neurologic symptoms, motor deficits, and neural injuries that range from 1 to 60% in the literature. Additional studies are required to further evaluate and monitor the short- and long-term safety, efficacy, outcomes, and complications of lateral transpsoas procedures.

Nerve injury during the transpsoas approach for lumbar fusion

2011 ◽  
Vol 15 (3) ◽  
pp. 280-284 ◽  
Author(s):  
John K. Houten ◽  
Lucien C. Alexandre ◽  
Rani Nasser ◽  
Adam L. Wollowick
Keyword(s):  
Nerve Injury ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Iliopsoas Muscle ◽  
Motor Deficits ◽  
Limited Information ◽  
Lateral Interbody Fusion ◽  
Transpsoas Approach ◽  
Clinical Events ◽  
Lateral Interbody

A lateral transpsoas approach to achieve interbody fusion in the lumbar spine using either the extreme lateral interbody fusion or direct lateral interbody fusion technique is an increasingly popular method to treat spinal disease. Dissection and dilation through the iliopsoas muscle places the lumbosacral plexus at risk for injury, but there is very limited information in the published literature about adverse clinical events resulting in postoperative motor deficits or reports of failure of electrophysiological monitoring to detect nerve injury. The authors present 2 cases of postoperative motor deficits following the transpsoas approach not detected by intraoperative monitoring, review the medical literature, and discuss strategies for complication avoidance.

scholarly journals Cage subsidence in lateral interbody fusion with transpsoas approach: intraoperative endplate injury or late-onset settling

2017 ◽  
Vol 1 (4) ◽  
pp. 203-210 ◽  
Author(s):  
Kotaro Satake ◽  
Tokumi Kanemura ◽  
Hiroaki Nakashima ◽  
Hidetoshi Yamaguchi ◽  
Naoki Segi ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Late Onset ◽  
Lateral Interbody Fusion ◽  
Transpsoas Approach ◽  
Cage Subsidence ◽  
Lateral Interbody

scholarly journals Clinical Evaluation of Microendoscopy-Assisted Oblique Lateral Interbody Fusion

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 135
Author(s):  
Tomohide Segawa ◽  
Hisashi Koga ◽  
Masahito Oshina ◽  
Katsuhiko Ishibashi ◽  
Yuichi Takano ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Outcome Measure ◽  
Operation Time ◽  
Secondary Outcome ◽  
Invasive Technique ◽  
Lateral Interbody Fusion ◽  
Surgical Methods ◽  
Significant Difference ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Background and objectives: Oblique Lateral Interbody Fusion (OLIF) is a widely performed, minimally invasive technique to achieve lumbar lateral interbody fusion. However, some complications can arise due to constraints posed by the limited surgical space and visual field. The purpose of this study was to assess the short-term postoperative clinical outcomes of microendoscopy-assisted OLIF (ME-OLIF) compared to conventional OLIF. Materials and Methods: We retrospectively investigated 75 consecutive patients who underwent OLIF or ME-OLIF. The age, sex, diagnosis, and number of fused levels were obtained from medical records. Operation time, estimated blood loss (EBL), and intraoperative complications were also collected. Operation time and EBL were only measured per level required for the lateral procedure, excluding the posterior fixation surgery. The primary outcome measure was assessed using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). The secondary outcome measure was assessed using the Oswestry Disability Index (ODI) and the European Quality of Life–5 Dimensions (EQ-5D), measured preoperatively and 1-year postoperatively. Results: This case series consisted of 14 patients in the OLIF group and 61 patients in the ME-OLIF group. There was no significant difference between the two groups in terms of the mean operative time and EBL (p = 0.90 and p = 0.50, respectively). The perioperative complication rate was 21.4% in the OLIF group and 21.3% in the ME-OLIF group (p = 0.99). In both groups, the postoperative JOABPEQ, EQ-5D, and ODI scores improved significantly (p < 0.001). Conclusions: Although there was no significant difference in clinical results between the two surgical methods, the results suggest that both are safe surgical methods and that microendoscopy-assisted OLIF could serve as a potential alternative to the conventional OLIF procedure.

scholarly journals Incisional hernia after extreme lateral interbody fusion on the lumbar spine: A case report

2021 ◽  
Vol 78 ◽  
pp. 130-132
Author(s):  
Masakazu Wakabayashi ◽  
Yurika Miyazaki ◽  
Kana Aoki ◽  
Hayato Yoshida ◽  
Kou Minoshima ◽  
...  
Keyword(s):  
Case Report ◽  
Lumbar Spine ◽  
Incisional Hernia ◽  
Interbody Fusion ◽  
Lateral Interbody Fusion ◽  
Extreme Lateral Interbody Fusion ◽  
Lateral Interbody
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