Imaging Anatomical Research on the Operative Windows of Oblique Lumbar Interbody Fusion

Liu, Liehua; Liang, Yao; Zhang, Hong; Wang, Haoming; Guo, Cui; Pu, Xiaobing; Zhang, Chengmin; Wang, Liyuan; Wang, Jian; Lv, Yingwen; Ren, Zhoukui; Zhou, Qiang; Deng, Zhong‐Liang

doi:10.1371/journal.pone.0163452

Cited by 48 publications

(64 citation statements)

References 17 publications

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“…Diana et al [24] analyzed 100 MR images of the lumbar spine to investigate the left-sided retroperitoneal oblique corridor of L2-S1 and got a conclusion of (1) 90% of the subjects had oblique access to each of the L2-L5 intervertebral discs and (2) only 69% had clear access to the L5-S1 intervertebral discs. Liu et al [25] analyzed 60 adults through abdominal computed tomography angiography and computed tomography of T12-S1 vertebral with three-dimensional reconstruction, then they deemed that the working corridor of each level related to OLIF has its own anatomical peculiarities, and not all levels are suitable for left-sided OLIF. And Chen et al [13] studied 400 subjects by lumbar spine MRI and concluded that OLIF in a left-sided approach can be suitable for the most Chinese patients from L2 to S1 segment; meanwhile, the more surgical space of the OLIF is seen in older female patients.…”

Section: Discussionmentioning

confidence: 99%

The OLIF working corridor based on magnetic resonance imaging: a retrospective research

Wang

Liu

et al. 2020

J Orthop Surg Res

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Objective: To provide an anatomical basis for the development of oblique lumbar interbody fusion (OLIF) in Chinese patients. Methods: Between November 2018 and June 2019, 300 patients' lumbar MRI data were reviewed. According to the Moro system and zone method described by us, the axial view was vertically divided into 6 zones (A, I II, III, IV, P) and was horizontally divided into 4 zones (R, a, b, c, L). The locations of left psoas muscle and the major artery at L2/3, L3/4, and L4/5 levels were evaluated by the grid system. The aortic bifurcation segments will also be evaluated at the level of the vertebral body or the disc. Results: At the L2/3 level, left psoas muscle and the major artery in zone Ib were found in 28.0% of subjects, in zone IIb in 20.3%, and in zone Ic in 20.0%; at the L3/4 level, in zone Ab in 20.7% of subjects, in zone Ac in 26.0%, and in zone Ic in 11.0%; and at the L4/5 level, areas in zone Ab in 31.0% of subjects, in zone Ac in 26.0%, and in zone Ib in 11.7%. The aortic bifurcation segments were mainly at the L4 level. The zone of the left psoas muscle at all levels, the zone of the major artery at L4/5 level, and the zone of the aortic bifurcation segments had significant correlation with gender difference (P < 0.05). Conclusion: The left-sided OLIF at L2-L5 disc levels can be a feasible type of surgery for lumbar interbody fusion in the majority of Chinese patients. Before the operation, in order to screen out the appropriate surgical approach, routine lumbar magnetic resonance imaging is recommended to analyze the patient's local anatomical features.

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Section: Discussionmentioning

confidence: 99%

The OLIF working corridor based on magnetic resonance imaging: a retrospective research

Wang

Liu

et al. 2020

J Orthop Surg Res

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“…The oblique access corridor has been investigated by many researchers. Liu et al [4] selected imaging data from 60 adults who underwent abdominal CTA and T12-S1 vertebral computed tomography (CT) with three-dimensional reconstruction, and the vascular window, bare window, and psoas major window were [5] dissected 20 fresh-frozen fulltorso cadaveric specimens and examined the oblique anatomical corridor of the L2-S1 discs. All measurements of the anatomical corridor were defined as the left lateral border of the aorta (or iliac artery).…”

Section: Discussionmentioning

confidence: 99%

A patient with left-sided inferior vena cava who received oblique lumbar interbody fusion surgery: a case report

et al. 2020

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Background: Oblique lateral interbody fusion surgery has become increasingly popular for lumbar degenerative diseases. The oblique corridor is between the psoas muscle and the retroperitoneal vessels, and its use could result in decreased tissue trauma, minimal blood loss, and short operation times. Patients who undergo oblique lateral interbody fusion surgery are always placed in the right lateral position to avoid damage to the inferior vena cava, which is typically a right-sided vessel. There is a substantial risk of vascular injury during the operation if there are anatomical variations in the vessels. Case presentation: A 77-year-old man, of the Han nationality, with lumbar spinal stenosis underwent stand-alone oblique lateral interbody fusion surgery. Transverse magnetic resonance imaging of the lumbar spine indicated that his inferior vena cava was left-sided. A three-dimensional reconstructed image of abdominal computed tomography angiography showed that the inferior vena cava was located on the left side. Finally, the surgeon decided to change the position of our patient from a right lateral position to a left lateral position before the surgery. Conclusions: To date, this is the first reported case where a patient underwent oblique lateral interbody fusion surgery in a left lateral decubitus position due to a left-sided inferior vena cava. This case demonstrates that carefully reading radiological results is important for operation planning and avoiding anatomical complications.

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“…Its utility for correcting deformity has also been reported (7). Additionally, the use of transoperative neurophysiologic monitoring is not necessary (3).…”

Section: Advantages and Disadvantages Of The Lumbar Fusion Techniquesmentioning

confidence: 99%

“…Each technique has its advantages and disadvantages (1,2). OLIF is an emerging procedure that has progressively been used by spine surgeons (3,4). The retroperitoneal space allows direct access to the intervertebral space, thus avoiding injury to the paraspinal muscles, psoas muscle, and lumbar plexus (5,6).…”

Section: Introductionmentioning

confidence: 99%

Complications on minimally invasive oblique lumbar interbody fusion at L2–L5 levels: a review of the literature and surgical strategies

Quillo-Olvera¹,

Lin²,

Jo³

et al. 2018

Ann. Transl. Med.

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Fusion is the cornerstone in the treatment of an unstable degenerative lumbar spinal disease. Various techniques have been developed. Amongst these techniques exists the oblique lumbar interbody fusion (OLIF), which is the ante-psoas approach. Adequate restoration of disc height with large cages placed in the intervertebral space, indirect decompression, and correction of sagittal and coronal alignment can be achieved with OLIF procedure with the advantage of minimal risk for the psoas muscle and lumbar plexus. Nevertheless, this technique entails complications directly associated with the anatomical location where the fusion takes place. This surgical area is a window between the left lateral border of the aorta, or the left common iliac artery, and the anterior belly of the left psoas muscle. Vascular complications associated with the injury of the main vessels, segmental artery or iliolumbar vein of the lumbar spine have been reported, as well as urologic lesions due to ureter transgression, amongst others. Although these complications have been described in the literature, an article that complements this information with technical advice for its avoidance is yet to be published. This article is a review of the most frequent complications associated with the OLIF procedure in L2-L5 lumbar levels, as well as a description of technical strategies for the prevention of such complications.

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Imaging Anatomical Research on the Operative Windows of Oblique Lumbar Interbody Fusion

Cited by 48 publications

References 17 publications

The OLIF working corridor based on magnetic resonance imaging: a retrospective research

The OLIF working corridor based on magnetic resonance imaging: a retrospective research

A patient with left-sided inferior vena cava who received oblique lumbar interbody fusion surgery: a case report

Complications on minimally invasive oblique lumbar interbody fusion at L2–L5 levels: a review of the literature and surgical strategies

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