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Location variance of the great vessels while undergoing side-bend positioning changes during lateral interbody fusion

BACKGROUND: Minimally invasive lateral lumbar interbody fusion (LLIF) is an increasingly popular surgical technique that facilitates minimally invasive exposure, attenuated blood loss, and potentially improved arthrodesis rates. However, there is a paucity of evidence elucidating the risk of vascula...

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Autores principales: Joiner, Aaron, Gomez, Gilberto, Vatsia, Sohrab K., Ellett, Tyler, Pahl, Douglas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10198204/
https://www.ncbi.nlm.nih.gov/pubmed/37213583
http://dx.doi.org/10.4103/jcvjs.jcvjs_8_23
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author Joiner, Aaron
Gomez, Gilberto
Vatsia, Sohrab K.
Ellett, Tyler
Pahl, Douglas
author_facet Joiner, Aaron
Gomez, Gilberto
Vatsia, Sohrab K.
Ellett, Tyler
Pahl, Douglas
author_sort Joiner, Aaron
collection PubMed
description BACKGROUND: Minimally invasive lateral lumbar interbody fusion (LLIF) is an increasingly popular surgical technique that facilitates minimally invasive exposure, attenuated blood loss, and potentially improved arthrodesis rates. However, there is a paucity of evidence elucidating the risk of vascular injury associated with LLIF, and no previous studies have evaluated the distance from the lumbar intervertebral space (IVS) to the abdominal vascular structures in a side-bend lateral decubitus position. Therefore, the purpose of this study is to evaluate the average distance, and changes in distance, from the lumbar IVS to the major vessels from supine to side-bend right and left lateral decubitus (RLD and LLD) positions simulating operating room positioning utilizing magnetic resonance imaging (MRI). METHODS: We independently evaluated lumbar MRI scans of 10 adult patients in the supine, RLD, and LLD positions, calculating the distance from each lumbar IVS to adjacent major vascular structures. RESULTS: At the cephalad lumbar levels (L1-L3), the aorta lies in closer proximity to the IVS in the RLD position, in contrast to the inferior vena cava (IVC), which is further from the IVS in the RLD. At the L3-S1 vertebral levels, the right and left common iliac arteries (CIA) are both further from the IVS in the LLD position, with the notable exception of the right CIA, which lies further from the IVS in the RLD at the L5-S1 level. At both the L4-5 and L5-S1 levels, the right common iliac vein (CIV) is further from the IVS in the RLD. In contrast, the left CIV is further from the IVS at the L4-5 and L5-S1 levels. CONCLUSION: Our results suggest that RLD positioning may be safer for LLIF as it affords greater distance away from critical venous structures, however, surgical positioning should be assessed at the discretion of the spine surgeon on a patient-specific basis.
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spelling pubmed-101982042023-05-20 Location variance of the great vessels while undergoing side-bend positioning changes during lateral interbody fusion Joiner, Aaron Gomez, Gilberto Vatsia, Sohrab K. Ellett, Tyler Pahl, Douglas J Craniovertebr Junction Spine Original Article BACKGROUND: Minimally invasive lateral lumbar interbody fusion (LLIF) is an increasingly popular surgical technique that facilitates minimally invasive exposure, attenuated blood loss, and potentially improved arthrodesis rates. However, there is a paucity of evidence elucidating the risk of vascular injury associated with LLIF, and no previous studies have evaluated the distance from the lumbar intervertebral space (IVS) to the abdominal vascular structures in a side-bend lateral decubitus position. Therefore, the purpose of this study is to evaluate the average distance, and changes in distance, from the lumbar IVS to the major vessels from supine to side-bend right and left lateral decubitus (RLD and LLD) positions simulating operating room positioning utilizing magnetic resonance imaging (MRI). METHODS: We independently evaluated lumbar MRI scans of 10 adult patients in the supine, RLD, and LLD positions, calculating the distance from each lumbar IVS to adjacent major vascular structures. RESULTS: At the cephalad lumbar levels (L1-L3), the aorta lies in closer proximity to the IVS in the RLD position, in contrast to the inferior vena cava (IVC), which is further from the IVS in the RLD. At the L3-S1 vertebral levels, the right and left common iliac arteries (CIA) are both further from the IVS in the LLD position, with the notable exception of the right CIA, which lies further from the IVS in the RLD at the L5-S1 level. At both the L4-5 and L5-S1 levels, the right common iliac vein (CIV) is further from the IVS in the RLD. In contrast, the left CIV is further from the IVS at the L4-5 and L5-S1 levels. CONCLUSION: Our results suggest that RLD positioning may be safer for LLIF as it affords greater distance away from critical venous structures, however, surgical positioning should be assessed at the discretion of the spine surgeon on a patient-specific basis. Wolters Kluwer - Medknow 2023 2023-03-13 /pmc/articles/PMC10198204/ /pubmed/37213583 http://dx.doi.org/10.4103/jcvjs.jcvjs_8_23 Text en Copyright: © 2023 Journal of Craniovertebral Junction and Spine https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Joiner, Aaron
Gomez, Gilberto
Vatsia, Sohrab K.
Ellett, Tyler
Pahl, Douglas
Location variance of the great vessels while undergoing side-bend positioning changes during lateral interbody fusion
title Location variance of the great vessels while undergoing side-bend positioning changes during lateral interbody fusion
title_full Location variance of the great vessels while undergoing side-bend positioning changes during lateral interbody fusion
title_fullStr Location variance of the great vessels while undergoing side-bend positioning changes during lateral interbody fusion
title_full_unstemmed Location variance of the great vessels while undergoing side-bend positioning changes during lateral interbody fusion
title_short Location variance of the great vessels while undergoing side-bend positioning changes during lateral interbody fusion
title_sort location variance of the great vessels while undergoing side-bend positioning changes during lateral interbody fusion
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10198204/
https://www.ncbi.nlm.nih.gov/pubmed/37213583
http://dx.doi.org/10.4103/jcvjs.jcvjs_8_23
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