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Exposure of the Lumbosacral Plexus by Using the Pararectus Approach: A Technical Note.
Sonja Häckel1, Samuel Christen1,2, Esther Vögelin1
1Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital Bern, University Bern, Bern, Switzerland.
Operative Neurosurgery (Hagerstown, Md.)
|October 13, 2022
Summary
A new pararectus surgical approach offers safe and effective visualization for lumbosacral plexus pathologies. This minimally invasive technique successfully treated nerve tumors and injuries with excellent patient recovery.
Area of Science:
- Neurosurgery
- Surgical Anatomy
Background:
- Surgical exploration of the lumbosacral plexus is complex.
- Existing methods include invasive open surgery and laparoscopy.
Purpose of the Study:
- To present a novel surgical technique for exploring lumbosacral plexopathies.
- The technique aims to address conditions like nerve tumors and iatrogenic injuries.
Main Methods:
- Retrospective evaluation of 4 patients (2017-2019) with lumbosacral plexus issues.
- All patients underwent neurolysis via a single-incision, intrapelvic, extraperitoneal pararectus approach.
- Mean follow-up was 23.5 months.
Main Results:
- Successful visualization of lumbosacral plexus pathologies in all cases.
- The extraperitoneal pararectus approach proved feasible for this indication.
- No major complications were reported, with good patient recovery.
Conclusions:
- The pararectus approach provides excellent visualization of the lumbar plexus.
- It is effective for intrapelvic lesions affecting the femoral and sciatic nerves.
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