scholarly journals Oblique Lumbar Interbody Fusion With Stereotactic Navigation: Technical Note

2020 ◽  
Vol 10 (2_suppl) ◽  
pp. 94S-100S
Author(s):  
Winward Choy ◽  
Rory Richard Mayer ◽  
Praveen V. Mummaneni ◽  
Dean Chou
Keyword(s):  
Interbody Fusion ◽  
Preoperative Evaluation ◽  
Vena Cava ◽  
Technical Note ◽  
Invasive Technique ◽  
Lumbar Interbody Fusion ◽  
Evaluation Approach ◽  
Surgical Technical ◽  
Oblique Lumbar Interbody Fusion ◽  
Technical Considerations

Study Design: Surgical technical note. Objectives: Describe the preoperative evaluation, approach, and technical considerations for an oblique lumbar interbody fusion using neuronavigation. Methods: A thorough review of previous technical and anatomic descriptions for pre- and transpsoas interbody techniques was performed and incorporated into the technical considerations warranting discussion for a navigated oblique lateral interbody fusion. Results: The prepsoas technique, also known as an oblique lumbar interbody fusion (OLIF), is an alternative approach for lumbar interbody fusion that utilizes a retroperitoneal corridor between the aorta/inferior vena cava. This corridor is devoid of neurovascular structures and obviates the need for real time electromyography monitoring. This approach spares the psoas and provides direct visualization of key structures and minimizes risk of injury to the great vessels, ureter, and lumbar plexus. Conclusions: A navigated prepsoas retroperitoneal approach is an effective minimally invasive technique for lumbar interbody fusion that may help mitigate some of the vascular and neurologic complications present with anterior lumbar interbody fusion or lateral lumbar interbody fusion and minimize radiation exposure to the surgeon.

scholarly journals Stereotactic navigation for the prepsoas oblique lateral lumbar interbody fusion: technical note and case series

2017 ◽  
Vol 43 (2) ◽  
pp. E14 ◽  
Author(s):  
Anthony M. DiGiorgio ◽  
Caleb S. Edwards ◽  
Michael S. Virk ◽  
Praveen V. Mummaneni ◽  
Dean Chou
Keyword(s):  
Interbody Fusion ◽  
Case Series ◽  
Psoas Muscle ◽  
Technical Note ◽  
Invasive Technique ◽  
Lumbar Interbody Fusion ◽  
Lateral Lumbar Interbody Fusion ◽  
Transpsoas Approach ◽  
Technical Report ◽  
Stereotactic Navigation

The prepsoas retroperitoneal approach is a minimally invasive technique used for anterior lumbar interbody fusion. The approach may have a more favorable risk profile than the transpsoas approach, decreasing the risks that come with dissecting through the psoas muscle. However, the oblique angle of the spine in the prepsoas approach can be disorienting and challenging. This technical report provides an overview of the use of navigation in prepsoas oblique lateral lumbar interbody fusion in a series of 49 patients.

Microscopic Anterior Neural Decompression Combined with Oblique Lumbar Interbody Fusion—A Technical Note

2019 ◽  
Vol 121 ◽  
pp. 37-43 ◽  
Author(s):  
Sourabh Chachan ◽  
Junseok Bae ◽  
Sang-Ho Lee ◽  
Ju-Wan Suk ◽  
Sang-Ha Shin
Keyword(s):  
Interbody Fusion ◽  
Technical Note ◽  
Lumbar Interbody Fusion ◽  
Oblique Lumbar Interbody Fusion

scholarly journals Changes in the Operative Corridor in Oblique Lumbar Interbody Fusion Between Preoperative Imaging and Intraoperative Cone-Beam Computed Tomography Using Morphometric Analysis

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Aqib Zehri ◽  
Hector Enrique Soriano-Baron ◽  
Wesley Hsu ◽  
Matthew Neal ◽  
Jonathan L Wilson
Keyword(s):  
Computed Tomography ◽  
Mr Imaging ◽  
Interbody Fusion ◽  
Lateral Decubitus Position ◽  
Cone Beam ◽  
Preoperative Imaging ◽  
Invasive Technique ◽  
Lumbar Interbody Fusion ◽  
Oblique Lumbar Interbody Fusion ◽  
Lateral Decubitus

Abstract INTRODUCTION Oblique lumbar interbody fusion (OLIF) is a minimally-invasive technique that relies on a sufficient corridor anterior to the psoas and posterior to vascular structures.This intraoperative corridor is evaluated on preoperative computed tomography (CT) and/or magnetic resonance (MR) imaging to guide patient selection.Previous cadaveric studies and preoperative MR imaging analysis have examined this corridor to determine corridor variations along right- and left-sided approaches and among patient characteristics.This is the first study that directly evaluates the true intraoperative corridor in the lateral decubitus position based on intraoperative 3D imaging. METHODS We performed a retrospective evaluation identifying patients > 18 yr old who had undergone an OLIF via a left-sided approach at 2 tertiary care centers from 2016 to 2018. Patients with scoliosis greater than 20 degrees, transitional anatomy, and psoas abnormalities were excluded.We recorded demographics and the intraoperative corridor defined by the distance between the left lateral border of the aorta or iliac vessels and anteromedial border of the psoas from L1-L2 through L4-5 disc spaces.This corridor was measured on supine, preoperative MR axial imaging and subsequent intraoperative 3D cone beam CT acquired in the right lateral decubitus position. RESULTS A total of 33 patients, 15 of whom were female, were included in this study.The average age was 65.4 and body mass index (BMI) was 31 kg/m2.There was a statistically significant increase (P < .05) in the intraoperative corridor from supine to lateral decubitus positioning at all levels.The greatest increase in corridor size was noted at L1-2 (3.1 cm) and least at L4-5 (2.1 cm).There was no statistically significant difference between age, BMI, or gender in the preoperative versus intraoperative corridor. CONCLUSION This is the first study to provide objective evidence to support that lateral decubitus positioning increases the intraoperative corridor for anterior to the psoas techniques.This information should increase confidence with an anterior to the psoas approach if there is adequate corridor size on supine preoperative imaging evaluation.

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