Anatomical positional changes in the lateral lumbar interbody fusion

Gandhi, Shashank V; Dugan, Robert E.; Farber, S. Harrison; Godzik, Jakub; Alhilali, Lea; Uribe, Juan S.

doi:10.1007/s00586-022-07195-x

Cited by 9 publications

(15 citation statements)

References 15 publications

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“…In comparing the 2 LDPs, the aorta and iliac vessels did not change in their positions when the hips were flexed or extended. However, when the vessels were compared in a lateral-flexed position with a prone-extended position, the aorta moved slightly laterally and to the left, but did not change in caliber 36 . An understanding of the abdominal vasculature and the effect of different surgical positions can help with preoperative planning and avoidance of catastrophic arterial injuries.…”

Section: Arterial Injurymentioning

confidence: 84%

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Complications of Lateral Decubitus Positioning During Orthopaedic Surgery

et al. 2023

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Lateral decubitus positioning is a nonanatomical position used for multiple orthopaedic procedures to obtain adequate surgical exposure.» Unique ophthalmologic, musculoskeletal, neurovascular, and hemodynamic complications may arise inadvertently from positioning.» Orthopaedic surgeons should be aware of the possible complications that may manifest from placing patients in the lateral decubitus position to adequately prevent and to properly manage them.

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Section: Arterial Injurymentioning

confidence: 84%

“…In an anatomic study of 10 healthy volunteers, Gandhi et al obtained MRIs of these individuals in 5 surgical positions, including lateral decubitus with the hips flexed and extended 36 . In comparing the 2 LDPs, the aorta and iliac vessels did not change in their positions when the hips were flexed or extended.…”

Section: Arterial Injurymentioning

confidence: 99%

Complications of Lateral Decubitus Positioning During Orthopaedic Surgery

et al. 2023

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“…Caution is required in the vascular assessment as vessels may move under gravity in the lateral decubitus position when assessing the supine anatomy. 15,16…”

Section: Methodsmentioning

confidence: 99%

“…21 Positioning of the patient for MRI assessment and the operation should be considered as the psoas muscle is more anterior when sitting and in the lateral position than when supine. 16,22…”

Section: Methodsmentioning

confidence: 99%

“…Caution is required in the vascular assessment as vessels may move under gravity in the lateral decubitus position when assessing the supine anatomy. 15,16 Careful assessment of the psoas anatomy is required due to the risk of lumbosacral plexus injury. The plexus is located in the posterior third of the muscle, becoming more anterior as it moves caudally.…”

Section: Anterior Psoasmentioning

confidence: 99%

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Lateral lumbar interbody fusion at L4-L5 has a low rate of complications in appropriately selected patients when using a standardized surgical technique

Buckland,

Huynh,

Menezes

et al. 2024

Bone Joint J

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AimsThe aim of this study was to reassess the rate of neurological, psoas-related, and abdominal complications associated with L4-L5 lateral lumbar interbody fusion (LLIF) undertaken using a standardized preoperative assessment and surgical technique.MethodsThis was a multicentre retrospective study involving consecutively enrolled patients who underwent L4-L5 LLIF by seven surgeons at seven institutions in three countries over a five-year period. The demographic details of the patients and the details of the surgery, reoperations and complications, including femoral and non-femoral neuropraxia, thigh pain, weakness of hip flexion, and abdominal complications, were analyzed. Neurological and psoas-related complications attributed to LLIF or posterior instrumentation and persistent symptoms were recorded at one year postoperatively.ResultsA total of 517 patients were included in the study. Their mean age was 65.0 years (SD 10.3) and their mean BMI was 29.2 kg/m2 (SD 5.5). A mean of 1.2 levels (SD 0.6) were fused with LLIF, and a mean of 1.6 (SD 0.9) posterior levels were fused. Femoral neuropraxia occurred in six patients (1.2%), of which four (0.8%) were LLIF-related and two (0.4%) had persistent symptoms one year postoperatively. Non-femoral neuropraxia occurred in nine patients (1.8%), one (0.2%) was LLIF-related and five (1.0%) were persistent at one year. All LLIF-related neuropraxias resolved by one year. A total of 32 patients (6.2%) had thigh pain, 31 (6.0%) were LLIF-related and three (0.6%) were persistent at one year. Weakness of hip flexion occurred in 14 patients (2.7%), of which eight (1.6%) were LLIF-related and three (0.6%) were persistent at one year. No patients had bowel injury, three (0.6%) had an intraoperative vascular injury (not LLIF-related), and five (1.0%) had ileus. Reoperations occurred in five patients (1.0%) within 30 days, 37 (7.2%) within 90 days, and 41 (7.9%) within one year postoperatively.ConclusionLLIF involving the L4-L5 disc level has a low rate of persistent neurological, psoas-related, and abdominal complications in patients with the appropriate indications and using a standardized surgical technique.Cite this article: Bone Joint J 2024;106-B(1):53–61.

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