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Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position
STUDY DESIGN: Cadaveric study. OBJECTIVE: To compare the position of the femoral nerve within the lumbar plexus at the L4-L5 disc space in the lateral decubitus vs prone position. METHODS: Seven lumbar plexus specimens were dissected and the femoral nerve within the psoas muscle was identified and m...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10556917/ https://www.ncbi.nlm.nih.gov/pubmed/34617812 http://dx.doi.org/10.1177/21925682211049170 |
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author | Alluri, Ram Clark, Nicholas Sheha, Evan Shafi, Karim Geiselmann, Matthew Kim, Han Jo Qureshi, Sheeraz Dowdell, James |
author_facet | Alluri, Ram Clark, Nicholas Sheha, Evan Shafi, Karim Geiselmann, Matthew Kim, Han Jo Qureshi, Sheeraz Dowdell, James |
author_sort | Alluri, Ram |
collection | PubMed |
description | STUDY DESIGN: Cadaveric study. OBJECTIVE: To compare the position of the femoral nerve within the lumbar plexus at the L4-L5 disc space in the lateral decubitus vs prone position. METHODS: Seven lumbar plexus specimens were dissected and the femoral nerve within the psoas muscle was identified and marked with radiopaque paint. Lateral fluoroscopic images of the cadaveric specimens in the lateral decubitus vs prone position were obtained. The location of the radiopaque femoral nerve at the L4-L5 disc space was normalized as a percentage of the L5 vertebral body (0% indicates posterior location and 100% indicates anterior location at the L4-L5 disc space). The location of the femoral nerve at L4-L5 in the lateral decubitus vs prone position was compared using a paired t test. RESULTS: In the lateral decubitus position, the femoral nerve was located 28% anteriorly from the posterior edge of the L4-L5 disc space, and in the prone position, the femoral nerve was relatively more posterior, located 18% from the posterior edge of the L4-L5 disc space (P = .037). CONCLUSIONS: The femoral nerve was on average more posteriorly located at the L4-L5 disc space in the prone position compared to lateral decubitus. This more posterior location allows for a larger safe zone at the L4-L5 disc space, which may decrease the incidence of neurologic complications associated with Lateral lumbar interbody fusion in the prone vs lateral decubitus position; however, further studies are needed to evaluate this possible clinical correlation. |
format | Online Article Text |
id | pubmed-10556917 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-105569172023-10-07 Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position Alluri, Ram Clark, Nicholas Sheha, Evan Shafi, Karim Geiselmann, Matthew Kim, Han Jo Qureshi, Sheeraz Dowdell, James Global Spine J Original Articles STUDY DESIGN: Cadaveric study. OBJECTIVE: To compare the position of the femoral nerve within the lumbar plexus at the L4-L5 disc space in the lateral decubitus vs prone position. METHODS: Seven lumbar plexus specimens were dissected and the femoral nerve within the psoas muscle was identified and marked with radiopaque paint. Lateral fluoroscopic images of the cadaveric specimens in the lateral decubitus vs prone position were obtained. The location of the radiopaque femoral nerve at the L4-L5 disc space was normalized as a percentage of the L5 vertebral body (0% indicates posterior location and 100% indicates anterior location at the L4-L5 disc space). The location of the femoral nerve at L4-L5 in the lateral decubitus vs prone position was compared using a paired t test. RESULTS: In the lateral decubitus position, the femoral nerve was located 28% anteriorly from the posterior edge of the L4-L5 disc space, and in the prone position, the femoral nerve was relatively more posterior, located 18% from the posterior edge of the L4-L5 disc space (P = .037). CONCLUSIONS: The femoral nerve was on average more posteriorly located at the L4-L5 disc space in the prone position compared to lateral decubitus. This more posterior location allows for a larger safe zone at the L4-L5 disc space, which may decrease the incidence of neurologic complications associated with Lateral lumbar interbody fusion in the prone vs lateral decubitus position; however, further studies are needed to evaluate this possible clinical correlation. SAGE Publications 2021-10-07 2023-09 /pmc/articles/PMC10556917/ /pubmed/34617812 http://dx.doi.org/10.1177/21925682211049170 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Articles Alluri, Ram Clark, Nicholas Sheha, Evan Shafi, Karim Geiselmann, Matthew Kim, Han Jo Qureshi, Sheeraz Dowdell, James Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position |
title | Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position |
title_full | Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position |
title_fullStr | Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position |
title_full_unstemmed | Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position |
title_short | Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position |
title_sort | location of the femoral nerve in the lateral decubitus versus prone position |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10556917/ https://www.ncbi.nlm.nih.gov/pubmed/34617812 http://dx.doi.org/10.1177/21925682211049170 |
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