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Comparative Analysis of Vascular Structures in OLIF51 and Lateral Corridor Approach under Supine MRI and Intraoperative Enhanced CT in Lateral Decubitus Position
Kotani, Y.; Tachi, H.; Ikeura, A.; Tanaka, T.; Saito, T. Comparative Analysis of Vascular Structures in OLIF51 and the Lateral Corridor Approach under Supine MRI and Intraoperative Enhanced CT in the Lateral Decubitus Position. Medicina2024, 60, 326.
Kotani, Y.; Tachi, H.; Ikeura, A.; Tanaka, T.; Saito, T. Comparative Analysis of Vascular Structures in OLIF51 and the Lateral Corridor Approach under Supine MRI and Intraoperative Enhanced CT in the Lateral Decubitus Position. Medicina 2024, 60, 326.
Kotani, Y.; Tachi, H.; Ikeura, A.; Tanaka, T.; Saito, T. Comparative Analysis of Vascular Structures in OLIF51 and the Lateral Corridor Approach under Supine MRI and Intraoperative Enhanced CT in the Lateral Decubitus Position. Medicina2024, 60, 326.
Kotani, Y.; Tachi, H.; Ikeura, A.; Tanaka, T.; Saito, T. Comparative Analysis of Vascular Structures in OLIF51 and the Lateral Corridor Approach under Supine MRI and Intraoperative Enhanced CT in the Lateral Decubitus Position. Medicina 2024, 60, 326.
Abstract
Background and objectives: As the oblique lateral interbody fusion at L5/S1 (OLIF51) and lateral corridor approach (LCA) have gained popularity, the understanding of precise vascular structure at L5/S1 level is indispensable. The objectives of this study were to investigate the vascular anatomy at L5/S1 level, and to compare the movement of vascular tissue between supine and lateral decubitus position using the intraoperative enhanced CT and MRI. Materials and Methods: A total of 43 patients who underwent either OLIF51 or LCA were investigated with the average age at surgery of 60.4 (37-80) years old. The preoperative MRI was taken to observe axial and sagittal anatomy of vascular position under supine position. The intraoperative vein-enhanced CT was taken just before incision in the right decubitus position, and compared to supine MRI anatomy. The iliolumbar vein appearance and its types were also classified. Results: The average vascular window allowed for OLIF51 was 22.8 mm and 34.1 mm at either L5 caudal endplate or S1 cephalad endplate level, respectively. It allowed for LCA was 14.2 mm and 12.6 mm at either level, respectively. The left common iliac vein moved 3.8 mm and 6.9 mm to right direction at either level from supine to right decubitus position, respectively. The bifurcation moved 6.3 mm to caudal direction from supine to right decubitus. The iliolumbar vein was located at 31 mm lateral from midline, and MRI detection rate was 52%. Conclusions: The precise measurement of vascular anatomy indicated that OLIF51 approach was the standard minimally invasive anterior approach for L5/S1 disc level compared to LCA, however, there were many variations in quantitative anatomy as well as significant vascular movements between supine and right decubitus position. In the clinical setting of OLIF51 and LCA surgeries, the careful preoperative evaluation and intraoperative 3D imaging are recommended for the safe and accurate surgery.
Medicine and Pharmacology, Orthopedics and Sports Medicine
Copyright:
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