An Expanded Surgical Corridor of Oblique Lateral Interbody Fusion at L4–5: A Magnetic Resonance Imaging Study
Objective We introduced a new preoperative method, the “expanded surgical corridor,” to evaluate the actual safety corridor, which may expand the possibility of performing oblique lateral interbody fusion (OLIF). Methods Axial T2-weighted magnetic resonance images at the L4–5 disc level of 511 lumba...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2023-12-01
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| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://e-neurospine.org/upload/pdf/ns-2346678-339.pdf |
| _version_ | 1827359562990092288 |
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| author | Worawat Limthongkul Pakawas Praisarnti Teerachat Tanasansomboon Natavut Prasertkul Vit Kotheeranurak Wicharn Yingsakmongkol Weerasak Singhatanadgige |
| author_facet | Worawat Limthongkul Pakawas Praisarnti Teerachat Tanasansomboon Natavut Prasertkul Vit Kotheeranurak Wicharn Yingsakmongkol Weerasak Singhatanadgige |
| author_sort | Worawat Limthongkul |
| collection | DOAJ |
| description | Objective We introduced a new preoperative method, the “expanded surgical corridor,” to evaluate the actual safety corridor, which may expand the possibility of performing oblique lateral interbody fusion (OLIF). Methods Axial T2-weighted magnetic resonance images at the L4–5 disc level of 511 lumbar degenerative disease patients was evaluated. The distance between the medial edge of the left-sided psoas muscle and the major artery was measured as the conventional surgical corridor (CSc). The distance between the major vein and lumbar plexus was measured as the expanded surgical corridor (ESc). Results The mean CSc and ESc were 13.9 ± 8.20 and 37.43 ± 10.1 mm, respectively. No surgical corridor was found in 7.05% of CSc and 1.76% of ESc, small corridor (≤ 1 cm) was found in 27.40% of CSc and 0.59% of ESc, moderate corridor (1–2 cm) was found in 42.07% of CSc and 1.96% of ESc, and large corridor (> 2 cm) was found in 23.48% of CSc and 95.69% of ESc. A total of 33.83% (45 of 133) of whom were preoperatively categorized as having a limited surgical corridor by conventional measurement, underwent OLIF L4–5 successfully. Conclusion By using the ESc, only 2.35% were categorized as having a limited surgical corridor. The other 97.65% of the patients had an approachable corridor that could be successfully operated by experienced spine surgeons who employ meticulous surgical dissection and thorough understanding of the anatomical structures. The ESc may represent true accessibility to the disc space for OLIF, particularly at the L4–5 level. |
| first_indexed | 2024-03-08T06:31:00Z |
| format | Article |
| id | doaj.art-158381c4dfd144edb5c48746e6a90766 |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T06:31:00Z |
| publishDate | 2023-12-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-158381c4dfd144edb5c48746e6a907662024-02-03T11:19:39ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912023-12-012041450145610.14245/ns.2346678.3391514An Expanded Surgical Corridor of Oblique Lateral Interbody Fusion at L4–5: A Magnetic Resonance Imaging StudyWorawat Limthongkul0Pakawas Praisarnti1Teerachat Tanasansomboon2Natavut Prasertkul3Vit Kotheeranurak4Wicharn Yingsakmongkol5Weerasak Singhatanadgige6 Department of Orthopedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand Department of Orthopedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand Department of Orthopedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand Department of Orthopedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand Department of Orthopedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand Department of Orthopedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, ThailandObjective We introduced a new preoperative method, the “expanded surgical corridor,” to evaluate the actual safety corridor, which may expand the possibility of performing oblique lateral interbody fusion (OLIF). Methods Axial T2-weighted magnetic resonance images at the L4–5 disc level of 511 lumbar degenerative disease patients was evaluated. The distance between the medial edge of the left-sided psoas muscle and the major artery was measured as the conventional surgical corridor (CSc). The distance between the major vein and lumbar plexus was measured as the expanded surgical corridor (ESc). Results The mean CSc and ESc were 13.9 ± 8.20 and 37.43 ± 10.1 mm, respectively. No surgical corridor was found in 7.05% of CSc and 1.76% of ESc, small corridor (≤ 1 cm) was found in 27.40% of CSc and 0.59% of ESc, moderate corridor (1–2 cm) was found in 42.07% of CSc and 1.96% of ESc, and large corridor (> 2 cm) was found in 23.48% of CSc and 95.69% of ESc. A total of 33.83% (45 of 133) of whom were preoperatively categorized as having a limited surgical corridor by conventional measurement, underwent OLIF L4–5 successfully. Conclusion By using the ESc, only 2.35% were categorized as having a limited surgical corridor. The other 97.65% of the patients had an approachable corridor that could be successfully operated by experienced spine surgeons who employ meticulous surgical dissection and thorough understanding of the anatomical structures. The ESc may represent true accessibility to the disc space for OLIF, particularly at the L4–5 level.http://e-neurospine.org/upload/pdf/ns-2346678-339.pdfoblique surgical corridoroblique lateral interbody fusionlateral lumbar interbody fusion |
| spellingShingle | Worawat Limthongkul Pakawas Praisarnti Teerachat Tanasansomboon Natavut Prasertkul Vit Kotheeranurak Wicharn Yingsakmongkol Weerasak Singhatanadgige An Expanded Surgical Corridor of Oblique Lateral Interbody Fusion at L4–5: A Magnetic Resonance Imaging Study Neurospine oblique surgical corridor oblique lateral interbody fusion lateral lumbar interbody fusion |
| title | An Expanded Surgical Corridor of Oblique Lateral Interbody Fusion at L4–5: A Magnetic Resonance Imaging Study |
| title_full | An Expanded Surgical Corridor of Oblique Lateral Interbody Fusion at L4–5: A Magnetic Resonance Imaging Study |
| title_fullStr | An Expanded Surgical Corridor of Oblique Lateral Interbody Fusion at L4–5: A Magnetic Resonance Imaging Study |
| title_full_unstemmed | An Expanded Surgical Corridor of Oblique Lateral Interbody Fusion at L4–5: A Magnetic Resonance Imaging Study |
| title_short | An Expanded Surgical Corridor of Oblique Lateral Interbody Fusion at L4–5: A Magnetic Resonance Imaging Study |
| title_sort | expanded surgical corridor of oblique lateral interbody fusion at l4 5 a magnetic resonance imaging study |
| topic | oblique surgical corridor oblique lateral interbody fusion lateral lumbar interbody fusion |
| url | http://e-neurospine.org/upload/pdf/ns-2346678-339.pdf |
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