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Retroperitoneal oblique corridor to the L2-S1 intervertebral discs: an MRI study
Diana M Molinares1, Timothy T Davis1, Daniel A Fung1
1Orthopedic Pain Specialists, Santa Monica, California.
Journal of Neurosurgery. Spine
|October 10, 2015
Summary
This study analyzed lumbar spine MR images to identify an oblique corridor for surgical access, avoiding the psoas muscle. Findings confirm a viable retroperitoneal corridor for minimally invasive lumbar spine surgery.
Area of Science:
- Neurosurgery
- Radiology
- Spine Surgery
Background:
- Minimally invasive spine surgery aims to reduce complications.
- The transpsoas approach carries risks of neurological injury.
- An alternative retroperitoneal oblique corridor could offer a safer surgical access route.
Purpose of the Study:
- To analyze lumbar spine MRI scans and document the oblique corridor.
- To assess the space between the psoas muscle and great vessels for surgical access.
- To evaluate oblique access to the L5-S1 disc space.
Main Methods:
- One hundred thirty-three lumbar spine MRI studies were reviewed.
- The oblique corridor was defined as the space between the aorta/iliac artery and the psoas muscle.
- Measurements were taken at lumbar disc levels L2-S1.
Main Results:
- A significant oblique corridor was identified in 90% of MR images for L2-5 disc access.
- Access to the L5-S1 disc space was feasible in 69% of cases.
- Aortic bifurcation and iliac vein confluence levels varied, impacting L5-S1 access probability.
Conclusions:
- The retroperitoneal oblique corridor is a viable surgical access route for L2-S1 intervertebral discs.
- Lumbar MRI can preoperatively identify the presence and suitability of this corridor.
- This approach may reduce postoperative neurological complications compared to transpsoas methods.
