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Three-dimensional Navigation-guided, Prone, Single-position, Lateral Lumbar Interbody Fusion Technique
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Oblique Lumbar Interbody Fusion With Stereotactic Navigation: Technical Note
Winward Choy1, Rory Richard Mayer1, Praveen V Mummaneni1
1University of California San Francisco, CA, USA.
Global Spine Journal
|June 13, 2020
Summary
This surgical note details the oblique lumbar interbody fusion (OLIF) using neuronavigation. This minimally invasive prepsoas approach offers an effective alternative to traditional methods, potentially reducing complications.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Minimally Invasive Surgery
Background:
- Oblique lumbar interbody fusion (OLIF) presents an alternative to anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF).
- The prepsoas technique utilizes a retroperitoneal corridor, avoiding direct contact with neurovascular structures within the psoas muscle.
Purpose of the Study:
- To describe the preoperative evaluation, surgical approach, and technical considerations for navigated oblique lumbar interbody fusion.
- To highlight the advantages of the prepsoas approach for lumbar interbody fusion.
Main Methods:
- A comprehensive review of existing technical and anatomical descriptions for pre- and transpsoas interbody fusion techniques was conducted.
- Technical considerations for navigated oblique lateral interbody fusion were incorporated based on this review.
Main Results:
- The prepsoas technique, or OLIF, offers an alternative lumbar interbody fusion approach via a retroperitoneal corridor.
- This corridor is free of neurovascular structures, negating the need for electromyography monitoring and sparing the psoas muscle.
- Direct visualization of key structures minimizes risks to great vessels, ureter, and lumbar plexus.
Conclusions:
- Navigated prepsoas retroperitoneal approach is an effective, minimally invasive technique for lumbar interbody fusion.
- This method may mitigate vascular and neurologic complications associated with ALIF and LLIF.
- The technique potentially minimizes radiation exposure for surgeons.
