Particularities of anterior fusion in L4-L5 isthmic spondylolisthesis

Moreau, Pierre Emmanuel; Flouzat-Lachaniette, Charles-Henri; Lebhar, Jonathan; Mirouse, G.; Poignard, Alexandre; Allain, J.

doi:10.1016/j.otsr.2016.05.006

Cited by 8 publications

(7 citation statements)

References 11 publications

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“…Consistent with the literature, our study indicates that the anatomical changes associated with LSTV can have a significant impact on spine surgery [ 12 , 17 ]. LSTV have bony alterations, whereby a partially asymmetric bony configuration of the LSTV could hinder pedicular screw fixation due to pedicle asymmetry [ 18 ].…”

Section: Discussionsupporting

confidence: 91%

“…However, approach in our collective of patients with 6LV was not hampered because of a lower seated iliac crest compared to the control group. In line with the literature, our study shows that a change in bony anatomy is accompanied by a change in soft tissue anatomy [ 3 , 12 , 17 ]. For an LLIF, the psoas muscle must be dissected for exposure of the intervertebral disc space.…”

Section: Discussionsupporting

confidence: 91%

“…Procedures coming from ventral retroperitoneal such as anterior lumbar interbody fusion (ALIF), lateral retroperitoneal approaches such as oblique (OLIF) or lateral lumbar interbody fusion (LLIF), dorsal procedures such as posterior (PLIF) or transforaminal lumbar interbody fusion (TLIF) as well as combined procedures with transpedicular screw fixation are commonly used for this purpose [16]. The literature shows that changes in bone anatomy in LSTV are accompanied by changes in soft tissue anatomy, which can significantly complicate approaches, especially for retroperitoneal procedures, in which the large abdominal vessels are exposed [3,12,17].…”

Section: Introductionmentioning

confidence: 99%

“…A lower mobility could be prevalent in LSTV segments with irregular articulation or partially bony fusion between the most caudal lumbar and the uppermost sacral vertebrae. This possibly results in a compensatory increased mobility of the segments lying above an LSTV and should may be taken into account as a cause of increased incidence of osteochondrosis, spondylarthrosis and disc degeneration [ 13 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Approach-related anatomical differences in patients with lumbo-sacral transitional vertebrae undergoing lumbar fusion surgery at level L4/5

Becker

Amini

Ziegeler

et al. 2022

Arch Orthop Trauma Surg

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Introduction Lumbo-sacral transitional vertebrae (LSTV) are accompanied by changes in soft tissue anatomy. The aim of our retrospective study was to evaluate the effects of LSTV as well as the number of free lumbar vertebrae on surgical approaches of ALIF, OLIF and LLIF at level L4/5. Material and methods We assessed the CTs of 819 patients. Of these, 53 had LSTV from which 11 had six (6LV) and 9 four free lumbar vertebrae (4LV). We matched them for sex and age to a control group. Results Patients with LSTV had a higher iliac crest and vena cava bifurcation, a greater distance between the common iliac veins and an anterior translation of the psoas muscle at level L4/5. In contrast, patients with 6LV had a lower iliac crest and aortic bifurcation, no differences in vena cava bifurcation and distance between the iliac veins compared to the control group. Conclusions For patients with LSTV and five or four free lumbar vertebrae, the LLIF approach at L4/5 may be hindered due to a high riding iliac crest as well as anterior shift of the psoas muscle. Whereas less mobilization and retraction of the iliac veins may reduce the risk of vascular injury at this segment by ALIF and OLIF. For patients with 6LV, a lower relative height of the iliac crest facilitates lateral approach during LLIF. For ALIF and OLIF, a stronger vessel retraction due to the deeper-seated vascular bifurcation is necessary during ALIF and is therefore potentially at higher risk for vascular injury.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Approach-related anatomical differences in patients with lumbo-sacral transitional vertebrae undergoing lumbar fusion surgery at level L4/5

Becker

Amini

Ziegeler

et al. 2022

Arch Orthop Trauma Surg

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“…Moreau и соавт. конкретизируют частоту коморбидности -60% случаев [33]. Отечественные авторы приводят данные о том, что у детей и подростков со спондилолистезом категории «highgrade» случаи люмбализации позвонка S I были диагностированы в 17,5%, сакрализации позвонка L Vв 6,34% клинических наблюдений [34].…”

Section: эпидемиологияunclassified

Transitional lumbosacral vertebrae

Скрябин

2023

Kazan Med J

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Transitional lumbosacral vertebrae in the form of SI lumbarization and LV sacralization are classified as spinal anomalies. In the domestic medical literature, there are few publications devoted to these pathological conditions. In the course of a study of the available literature on the problem of transitional lumbosacral vertebrae, it was found that the frequency of cases of transitional lumbosacral vertebrae diagnosis ranges from 4 to 30% of clinical cases. The share of patients with lumbar vertebrae accounts for an average of 40% of cases, the share of patients with sacralization of the vertebrae is 60% of clinical observations. Mutations in the Hox gene are considered to be the trigger for the development of pathology, and pain is usually the leading clinical symptom. Plain radiography, computed tomography and magnetic resonance imaging are used to diagnose the pathology. Radiation imaging of the entire spine is required to eliminate errors in vertebrae counting. The type of pathology is determined using various classifications. As conservative therapeutic agents, drug blockades applying anesthetics and hormonal drugs are used. The arsenal of surgical interventions includes resection of the enlarged transverse process of the supracacral vertebra, decompression of stenotic intervertebral foramina, impulsive radiofrequency ablation, and posterior fusion. Measures for the prevention of pathology are not currently developed.

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