Understanding Retroperitoneal Anatomy for Lateral Approach Spine Surgery

Kanemura, Tokumi; Satake, Kotaro; Nakashima, Hiroaki; Segi, Naoki; Ouchida, Jun; Yamaguchi, Hidetoshi; Imagama, Shiro

doi:10.22603/ssrr.1.2017-0008

Cited by 36 publications

(25 citation statements)

References 127 publications

(135 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The psoas major, which is directly visible, can then be easily checked. In this approach, lateroconal fascia which is the retroperitoneum of this part is sometimes visible [8] (Supplementary video clip 1). Because the intestinal tract is present in the abdominal side of this very thin membrane, extreme care must be taken.…”

Section: Methodsmentioning

confidence: 99%

Minimally Invasive Endoscopic-Assisted Lateral Lumbar Interbody Fusion: Technical Report and Preliminary Results

Kyoh¹

2019

Neurospine

View full text Add to dashboard Cite

Objective Lateral lumbar interbody fusion (LLIF) is a highly useful lumbar fusion surgical technique for degenerative spinal disease. However, many complications have already been reported. The purpose of this study is to report the concept, surgical technique, and clinical results of the first 70 consecutive cases treated with a safer and minimally invasive endoscopic-assisted LLIF (ELLIF). Methods This retrospective study included 70 cases involving 106 segments in which ELLIF was used to treat degenerative spinal disease. We examined the clinical progress, complications and analyzed radiographic images. Regarding the fusion rate, 49 cases involving 72 segments whose follow-up period was more than 7 months were evaluated. Results The mean of preoperative Numerical Rating Scale (NRS) was 7.0 and postoperative NRS was 1.4. Postoperative NRS had a significant correlation with the number of fusion segments (p = 0.028). The mean of preoperative disc space height, foraminal height, sagittal rotation angle, whole lumbar lordosis and sagittal translation distance were 3.3 mm, 14.3 mm, 2.4°, 9.7°, and 3.2 mm, respectively. Postoperative values were 9.4 mm, 17.9 mm, -4.9°, 36.3°, and 0.7 mm. The fusion rate was 79.2%. Complications included, transient psoas muscle weakness 1, sensory disturbance in the thigh 2, retroperitoneal injury 1, postoperative ileus possibly involving a retroperitoneal injury 1, and cage migration 4. Conclusion Using the ELLIF in the degenerative spinal disease, we obtained good radiological reduction and good clinical results. Our study confirms that ELLIF is safer and provides better results for degenerative spinal disease. However, the issue of cage migration remains to be resolved.

show abstract

Section: Methodsmentioning

confidence: 99%

Minimally Invasive Endoscopic-Assisted Lateral Lumbar Interbody Fusion: Technical Report and Preliminary Results

Kyoh¹

2019

Neurospine

View full text Add to dashboard Cite

show abstract

“…The retroperitoneum is divided into three individual compartments: the anterior pararenal space (APS), posterior pararenal spaces (PPS), and the perirenal space (PRS) [46]. APS includes ascending or descending colon, duodenal loop, pancreass.…”

Section: Visceral and Vascular Complicationsmentioning

confidence: 99%

Lateral Lumbar Interbody Fusion, Indications and Complications—An Updated Review

Chen¹,

Lai²,

Ma³

et al. 2020

Preprint

View full text Add to dashboard Cite

PurposeTo perform an updated and comprehensive review of LLIF; we will also introduce a new modified LLIF named as crenel lateral interbody fusion (CLIF) to reduce the approach-related complicationsMethodsA systematic and critical review of recent literature was conducted. The sources of the data were form PubMed, MEDLINE, Embase, and Cochrane. Key search terms were "transpsoas", "interbody fusion", "LLIF", "XLIF", and “DLIF”ResultsStand-alone LLIF has the risk of cage subsidence and non-union rate. LLIF has less complication compared with other approaches because of its minimal invasive, but it still has some specific complications.ConclusionLLIF is a safe, effective and lower complication rate technique when compared to other interbody fusion methods.

show abstract

“…In addition, the ATF may fuse with the posterior lamina of the posterior renal fascia and the blending site varies between patients. 4 , 5 Together, the multilaminated fascial structures anterior to the QL indicate the precision injection is of great difficult in the classic subcostal QL block. Based on the action mechanism of classic subcostal QL block, we think that it indicates the correct position of needle endpoint if the cranial spread of injected LA via the posterior pathway of lateral arcuate ligament could be confirmed under the ultrasound visualization.…”

Section: Introductionmentioning

confidence: 99%

A Modified Approach Below the Lateral Arcuate Ligament to Facilitate the Subcostal Anterior Quadratus Lumborum Block

Shi

Wang

2021

JPR

View full text Add to dashboard Cite

Purpose The subcostal quadratus lumborum (QL) block was used in postoperative analgesia for abdominal surgery. However, it is difficult to precisely put the needle tip into the target fascia compartment. In the current study, we proposed a modified approach to facilitate the subcostal QL block. Patients and Methods Twenty-four patients scheduled for laparoscopic renal surgery were enrolled. The modified QL block was placed preoperatively. The transducer was placed just laterally to the tip of L1 transverse process to perform the parasagittal scan. The needle was inserted in-plane and advanced toward the target compartment between the QL muscle and the anterior thoracolumbar fascia and just below the lateral arcuate ligament. The 20 mL of 0.5% ropivacaine was injected slowly if the saline spread cranially via the posterior pathway of lateral arcuate ligament was observed on the sonogram. Then, the paramedian transverse scanning at the level of T12-L1 was performed to observe the injectate diffusion. The dermatomal coverage of sensory block was tested at 5 min and 10 min after LA injections. The complications associated with the block were recorded. Results Twenty-three (95.8%) patients received the successful block. All patients achieved the sensory block dermatomes of T9–T12 and T6–L1, at 5 and 10 minutes after injection, respectively. The mean numbers of block dermatomes were 5.6±1.8 at 5 min and 6.5±2.2 at 10 min after injection. Two out of twenty-three (8.7%) patients achieved coverage as cephalad as T5 at 10 min after injections. The lunar-shaped spread of LA along the diaphragm into the T12 paravertebral space was observed in every patient. No complications occurred. Conclusion The modified subcostal QL block has the advantages of clear sonoanatomy, rapid onset time, and consistent dermatomal coverage and provides a new choice for postoperative analgesia of abdominal surgery. Trial Registration Chinese Clinical Trial Registry: ChiCTR2000029210.

show abstract

Understanding Retroperitoneal Anatomy for Lateral Approach Spine Surgery

Cited by 36 publications

References 127 publications

Minimally Invasive Endoscopic-Assisted Lateral Lumbar Interbody Fusion: Technical Report and Preliminary Results

Minimally Invasive Endoscopic-Assisted Lateral Lumbar Interbody Fusion: Technical Report and Preliminary Results

Lateral Lumbar Interbody Fusion, Indications and Complications—An Updated Review

A Modified Approach Below the Lateral Arcuate Ligament to Facilitate the Subcostal Anterior Quadratus Lumborum Block

Contact Info

Product

Resources

About