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Retrorenal colon: implications for percutaneous diskectomy
C A Helms1, P L Munk, W S Witt
1Department of Radiology, University of California San Francisco 94143.
Radiology
|June 1, 1989
Summary
Routine prone computed tomography (CT) is not necessary before percutaneous lumbar diskectomy. This imaging is rarely needed as retrorenal bowel, a potential complication, is found in less than 1% of patients.
Area of Science:
- Radiology
- Spinal Surgery
- Anatomy
Background:
- Percutaneous lumbar diskectomy is a minimally invasive surgical procedure.
- A retrorenal or retropsoas location of the colon is a rare anatomical variation.
- This anatomical variation could potentially lead to bowel perforation during diskectomy.
Purpose of the Study:
- To evaluate the necessity of routine prone computed tomography (CT) before percutaneous lumbar diskectomy.
- To determine the prevalence of retrorenal or retropsoas bowel in patients undergoing this procedure.
Main Methods:
- Retrospective review of 346 computed tomography (CT) studies performed with patients in the prone position.
- Analysis of CT findings to identify any retrorenal or retropsoas bowel.
- Correlation of anatomical findings with the potential risk of perforation during percutaneous diskectomy.
Main Results:
- Only one patient (0.29%) out of 346 evaluated had retrorenal or retropsoas bowel.
- The identified anatomical variation posed a potential risk for perforation during diskectomy.
- The extremely low prevalence suggests this is an uncommon finding.
Conclusions:
- Routine performance of prone CT in every patient undergoing percutaneous lumbar diskectomy is not considered necessary.
- The low prevalence of retrorenal bowel does not justify the routine use of this imaging modality.
- Further investigation may be needed to identify specific patient subgroups who might benefit from pre-procedural prone CT.