Perioperative outcomes in minimally invasive lumbar spine surgery: A systematic review

Skovrlj, Branko

doi:10.5312/wjo.v6.i11.996

Cited by 35 publications

(21 citation statements)

References 63 publications

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“…Modern anatomic descriptions typically list the innervation of the PMM as primarily from L1 and L2 (Dakwar et al, 2011a;Ahmadian et al, 2013) (Table 2). In recent anatomical studies, significant attention has been given to the relationship of the PMM to nerves of the lumbar plexus (Skovrlj et al, 2015) or uncommon anatomic variations (Cahill et al, 2012), rather than to the nerves supplying the muscle itself. However, a recent study aimed at establishing landmarks for percutaneous injection found "multiple" nerve branches to the psoas major, yielding an average of 3.7 branches per psoas major (Van Campenhout et al, 2010).…”

Section: Prior Anatomical Depictionsmentioning

confidence: 99%

“…Minimally invasive spinal surgical techniques have become increasingly popular because of the interest in avoiding muscular disruption and possible muscular atrophy; these techniques have been shown to decrease blood loss and reduce hospital length of stay (Wang et al, 2011;Waschke et al, 2014;Skovrlj et al, 2015). Minimally invasive lateral approaches to the spine involve intramuscular dissection of both the flank wall as well as the psoas major muscle (PMM) to gain access to spinal pathology, most commonly that involving the intervertebral (IV) disc or the vertebral body.…”

Section: Introductionmentioning

confidence: 99%

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Anatomy of psoas muscle innervation: Cadaveric study

et al. 2017

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Hip flexion weakness is relatively common after lateral transpsoas surgery. Persistent weakness may result from injury to the innervation of the psoas major muscles (PMMs); however, anatomical texts have conflicting descriptions of this innervation, and the branching pattern of the nerves within the psoas major, particularly relative to vertebral anatomy, has not been described. The authors dissected human cadavers to describe the branching pattern of nerves supplying the PMMs. Sixteen embalmed cadavers were dissected, and the fine branching pattern of the innervation to the PMM was studied in 24 specimens. The number of branches and width and length of each branch of nerves to the PMMs were quantified. Nerve branches innervating the PMMs arose from spinal nerve levels L1-L4, with an average of 6.3 ± 1.1 branches per muscle. The L1 nerve branch was the least consistently present, whereas L2 and L3 branches were the most robust, the most numerous, and always present. The nerve branches to the psoas major commonly crossed the intervertebral (IV) disc obliquely prior to ramification within the muscle; 76%, 80%, and 40% of specimens had a branch to the PMM cross the midportion of the L2-3, L3-4, and L4-5 IV discs, respectively. The PMMs are segmentally innervated from the L2-L4 ventral rami branches, where these branches course obliquely across the L2-3, L3-4, and L4-5 IV discs. Knowledge of the mapping of nerve branches to the PMMs may reduce injury and the incidence of persistent weak hip flexion during lateral transpsoas surgery. Clin. Anat. 30:479-486, 2017. © 2017 Wiley Periodicals, Inc.

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Section: Prior Anatomical Depictionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anatomy of psoas muscle innervation: Cadaveric study

et al. 2017

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“…15,16 Minimally invasive spine surgery has shown benefits such as lesser iatrogenic injury to the paravertebral muscles, decreased intraoperative bleeding, decreased complications associated with the surgical wound, lower consumption of narcotics for control of postoperative pain, shorter hospital stays, and resumption of daily activities in less time compared with conventional surgery. 17 In the technique presented here, only a small medial portion of the occipital tendon of the semispinalis capitis muscle, and the occipital and vertebral insertion of the posterior minor rectus capitis muscle were detached to reach the atlanto-occipital space. The remainder of the extensor neck muscles were preserved.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Craniocervical Decompression for Chiari 1 Malformation: An Operative Technique

Quillo-Olvera¹,

Navarro-Ramírez

Quillo-Olvera

et al. 2019

J Neurol Surg A Cent Eur Neurosurg

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Chiari malformation type 1 (CM-1) is an ectopia of the cerebellar tonsils below the foramen magnum that causes severe disability due to its neurologic symptoms. The treatment of choice for CM-1 is decompression of the craniovertebral junction (CVJ). In some patients only an extradural decompression by removing the atlanto-occipital ligament may be sufficient. In other patients, duraplasty is necessary. In this case, we report the operative technique used to treat a CM-1 in a 16-year-old male patient who presented with severe headache and gait instability. A micro-decompression of the suboccipital bone and posterior arch osteotomy of C1 through a 2-cm midline incision was performed under surgical microscope magnification. A duraplasty was performed through the same approach. The patient was discharged home after 2 days in the hospital and returned to regular activities at school 3 weeks after surgery. The minimally invasive technique presented here is a viable option for the posterior decompression of the CVJ in patients with CM-1 using a low-cost self-retaining retractor.

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“…With regard to the first criteria, a review by Skovrlj et al compared the minimally invasive versus the open procedure for laminectomy, TLIF, and direct lateral interbody fusion (DLIF). The authors reported MISS to be as effective as the analogous open procedures [ 10 ]. With respect to the second criteria, MISS procedures have also been shown to decrease injury to the multifidus muscle [ 2 ], decrease physiologic stress [ 11 ], as well as maintain the biomechanical properties of the spine [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Versus Open Laminectomy/Discectomy, Transforaminal Lumbar, and Posterior Lumbar Interbody Fusions: A Systematic Review

Imada

Huynh

Drazin

2017

Cureus

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Minimally invasive spine surgeries (MISS) are becoming increasingly favored as alternatives to open spine procedures because of the reduced blood loss, postoperative pain, and recovery time. Studies have shown mixed results regarding the efficacy and safety of minimally invasive procedures compared to the traditional, open counterparts. The objectives of this systematic analysis are to compare clinical outcomes between the three MISS and open procedures: (1) laminectomy/discectomy, (2) transforaminal lumbar interbody fusion (TLIF), and (3) posterior lumbar interbody fusion (PLIF). The Cochrane and PubMed databases were queried according to the preferred reporting items for systematic review and meta-analyses (PRISMA) statement. The primary outcome measures included the visual analog scale (VAS), the Oswestry disability index (ODI), and blood loss. A total of 32 studies were included in the analysis. Of the three procedures investigated, only MISS TLIF showed significantly improved VAS for leg pain (p = 0.02), ODI (p = 0.05), and reduced blood loss (p = 0.005). MISS-laminectomy/discectomy, TLIF, and PLIF appear to be similar in terms of postoperative pain and perioperative blood loss. MISS TLIF is perhaps more effective in specific outcome measures and results in less intraoperative blood loss than open TLIF.

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Perioperative outcomes in minimally invasive lumbar spine surgery: A systematic review

Cited by 35 publications

References 63 publications

Anatomy of psoas muscle innervation: Cadaveric study

Anatomy of psoas muscle innervation: Cadaveric study

Minimally Invasive Craniocervical Decompression for Chiari 1 Malformation: An Operative Technique

Minimally Invasive Versus Open Laminectomy/Discectomy, Transforaminal Lumbar, and Posterior Lumbar Interbody Fusions: A Systematic Review

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