Magnetic Resonance Imaging Study of Oblique Corridor and Trajectory to L1–L5 Intervertebral Disks in Lateral Position

• Published in: World neurosurgery Vol. 134; pp. e616 - e623
• Main Authors: Tao, Yiqing, Huang, Chunneng, Li, Fangcai, Chen, Qixin
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2020
• Subjects: Asian Continental Ancestry Group; China; Female; Humans; Intervertebral Disc - diagnostic imaging; Intervertebral Disc - surgery; Lateral position; Lumbar interbody fusion; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - surgery; Magnetic Resonance Imaging; Male; Middle Aged; Oblique corridor; Organ Size; Patient Positioning; Psoas Muscles - diagnostic imaging; Psoas Muscles - surgery; Retroperitoneal Space - blood supply; Retroperitoneal Space - diagnostic imaging; Retroperitoneal Space - surgery; Retroperitoneal vessel; Sex Characteristics; Spinal Fusion - methods; Trajectory; China; MRI; Retroperitoneal vessel; LIF; Oblique corridor; TLIF; Lateral position; Magnetic resonance imaging; ALIF; T2WI; Lumbar interbody fusion; Trajectory; PLIF; ATP; LLIF; OLIF
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2019.10.147

This study investigated the retroperitoneal oblique corridor and trajectory of L1−L5 as the lateral surgical access to the intervertebral disks in the Chinese population and detected the potential relationship between the corridor or trajectory and vertebral parameters, including disk axis, psoas muscle, and retroperitoneal vessel. Seventy magnetic resonance imaging studies performed from January 2017 to January 2019 were investigated. The oblique corridor was defined as the distance between the left lateral border of the retroperitoneal vessel and the anterior border of psoas. The trajectory was defined as the distance between the retroperitoneal vessel and lumbar plexus. The oblique corridor analysis to L1−L5 disks have the following mean distances: L1−2 13.36 mm, L2−3 13.36 mm, L3−4 12.37 mm, and L4−5 10.36 mm. There was no difference in the L1−L5 corridor between genders. And the position of retroperitoneal vessel was negatively correlated with the corridor width. The trajectory measurements to L1−L5 disks have the following mean distances: L1−2 27.44 mm, L2−3 30.86 mm, L3−4 30.73 mm, and L4−5 24.36 mm. Moreover, the vertebral parameters, including the disk axis and psoas muscle, were positively correlated with the trajectory width. Otherwise, the position of retroperitoneal vessel was negatively correlated with the trajectory width. Compared with previous studies, the safe surgical area of the Chinese is generally smaller than that of Caucasian. The position of the retroperitoneal vessel is the vital potential to limit the corridor and trajectory. Preoperative assessment of vertebral parameters, especially vascular structure, is essential for planning surgical process.