Modification of the Safe Corridor for Oblique Lumbar Interbody Fusion Based on Postural Changes and Body Composition. An Observational, Multicenter Study Using MRI
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Published:
Feb 15, 2024
Keywords:
OLIF, MISS, minimally invasive spine surgery
Main Article Content
Abstract
Introduction: Minimally invasive spine surgery (MISS) has gained popularity in recent years. New and less invasive techniques have emerged as the preferred procedures for certain pathologies. The size of the aorta-psoas corridor is decisive when choosing the oblique interbody fusion technique.
Objectives: To describe the changes in the size of the aorta-psoas corridor in the right lateral decubitus and supine decubitus positions by magnetic resonance imaging and their association with body mass index.
Materials and Methods: 13 volunteers underwent MRI of the disc spaces from L1-L2 to L4-L5 in the supine and right lateral decubitus positions. The corridor was measured, and the sizes at each level were compared.
Results: A statistically significant increase in the size of the aorta-psoas corridor and the artery-disc distance was obtained when positioning the patient in the right lateral decubitus position. However, these have no significant relationship with BMI.
Conclusions: The use of MRI in pre-surgical planning is extremely important. This study reveals the mobility of the abdominal structures. We can conclude that, as stated in the objective of the study, significant changes occur in the aorta-psoas corridor and the artery-disc distance when the patient is positioned in the right lateral decubitus position.
Objectives: To describe the changes in the size of the aorta-psoas corridor in the right lateral decubitus and supine decubitus positions by magnetic resonance imaging and their association with body mass index.
Materials and Methods: 13 volunteers underwent MRI of the disc spaces from L1-L2 to L4-L5 in the supine and right lateral decubitus positions. The corridor was measured, and the sizes at each level were compared.
Results: A statistically significant increase in the size of the aorta-psoas corridor and the artery-disc distance was obtained when positioning the patient in the right lateral decubitus position. However, these have no significant relationship with BMI.
Conclusions: The use of MRI in pre-surgical planning is extremely important. This study reveals the mobility of the abdominal structures. We can conclude that, as stated in the objective of the study, significant changes occur in the aorta-psoas corridor and the artery-disc distance when the patient is positioned in the right lateral decubitus position.
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de Zavalía, M., Gobbi, E., Mazzeo, J. J., Verna, B., Lanari Zubiaur, F., & Yeregui, S. (2024). Modification of the Safe Corridor for Oblique Lumbar Interbody Fusion Based on Postural Changes and Body Composition. An Observational, Multicenter Study Using MRI. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 89(1), 22-29. https://doi.org/10.15417/issn.1852-7434.2024.89.1.1806
Section
Clinical Research
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References
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lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) in lumbar spondylolisthesis: a
systematic review and meta-analysis. Spine J 2017;17(11):1712-21. https://doi.org/10.1016/j.spinee.2017.06.018
2. Fenton-White HA. Trailblazing: the historical development of the posterior lumbar interbody fusion (PLIF). Spine J 2021;21(9):1528-41. https://doi.org/10.1016/j.spinee.2021.03.016
3. Lan T, Hu SY, Zhang YT, Zheng YC, Zhang R, Shen Z, et al. Comparison between posterior lumbar interbody
fusion and transforaminal lumbar interbody fusion for the treatment of lumbar degenerative diseases: A systematic review and meta-analysis. World Neurosurg 2018;112:86-93. https://doi.org/10.1016/j.wneu.2018.01.021
4. Meng B, Bunch J, Burton D, Wang J. Lumbar interbody fusion: recent advances in surgical techniques and bone
healing strategies. Eur Spine J 2021;30(1):22-33. https://doi.org/10.1007/s00586-020-06596-0
5. Fleege C, Rickert M, Rauschmann M. PLIF- und TLIF-Verfahren. Indikation, Technik, Vor- und Nachteile [The
PLIF and TLIF techniques. Indication, technique, advantages, and disadvantages]. Orthopade 2015;44(2):114-23.
https://doi.org/10.1007/s00132-014-3065-9
6. Caelers IJMH, de Kunder SL, Rijkers K, van Hemert WLW, de Bie RA, Evers SMAA, et al. Comparison of (partial)
economic evaluations of transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion
(PLIF) in adults with lumbar spondylolisthesis: A systematic review. PLoS One 2021;16(2):e0245963.
https://doi.org/10.1371/journal.pone.0245963
7. Mobbs RJ, Phan K, Malham G, Seex K, Rao PJ. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. J Spine Surg 2015;1(1):2-18. https://doi.org/10.3978/j.issn.2414-469x.2015.10.05
8. Xu DS, Walker CT, Godzik J, Turner JD, Smith W, Uribe JS. Minimally invasive anterior, lateral, and oblique
lumbar interbody fusion: a literature review. Ann Transl Med 2018;6(6):104. https://doi.org/10.21037%2Fatm.2018.03.24
9. Teng I, Han J, Phan K, Mobbs R. A meta-analysis comparing ALIF, PLIF, TLIF and LLIF. J Clin Neurosci 2017;44:11-7. https://doi.org/10.1016/j.jocn.2017.06.013
10. Soriano-Sánchez JA, Baabor-Aqueveque M, Silva-Morales F. Philosophy and concepts of modern spine surgery. Acta Neurochir Suppl 2011;108:23-31. https://doi.org/10.1007/978-3-211-99370-5_5
11. Epstein NE. Review of risks and complications of extreme lateral interbody fusion (XLIF). Surg Neurol Int 2019;10:237. https://doi.org/10.25259/SNI_559_2019
12. Wert WG Jr, Sellers W, Mariner D, Obmann M, Song B, Ryer EJ, et al. Identifying risk factors for complications
during exposure for anterior lumbar interbody fusion. Cureus 2021;13(7):e16792. https://doi.org/10.7759/cureus.16792
13. Piazzolla A, Bizzoca D, Berjano P, Balsano M, Buric J, Carlucci S, et al. Major complications in extreme lateral
interbody fusion access: multicentric study by Italian S.O.L.A.S. group. Eur Spine J 2021;30(1):208-16. https://doi.org/10.1007/s00586-020-06542-0
14. Epstein NE. Incidence of major vascular injuries with extreme lateral interbody fusion (XLIF). Surg Neurol Int
2020;11:70. https://doi.org/10.25259%2FSNI_113_2020
15. Pojskic M, Saβ B, Völlger B, Nimsky C, Carl B. Extreme lateral interbody fusion (XLIF) in a consecutive series of
72 patients. Bosn J Basic Med Sci 2021;21(5):587-97. https://doi.org/10.17305/bjbms.2020.5261
16. Grimm BD, Leas DP, Poletti SC, Johnson DR 2nd. Postoperative complications within the first year after extreme lateral interbody fusion: Experience of the first 108 patients. Clin Spine Surg 2016;29(3):E151-6.
https://doi.org/10.1097/bsd.0000000000000121
17. Mayer HM. A new microsurgical technique for minimally invasive anterior lumbar interbody fusion. Spine (Phila Pa 1976) 1997;22(6):691-9. https://doi.org/10.1097/00007632-199703150-00023
18. Chung HW, Lee HD, Jeon CH, Chung NS. Comparison of surgical outcomes between oblique lateral interbody
fusion (OLIF) and anterior lumbar interbody fusion (ALIF). Clin Neurol Neurosurg 2021;209:106901. https://doi.org/10.1016/j.clineuro.2021.106901
19. Chang MC, Kim GU, Choo YJ, Lee GW. Transforaminal lumbar interbody fusion (TLIF) versus oblique lumbar
interbody fusion (OLIF) in interbody fusion technique for degenerative spondylolisthesis: A systematic review and meta-analysis. Life (Basel) 2021;11(7):696. https://doi.org/10.3390/life11070696
20. Aleinik AY, Mlyavykh SG, Qureshi S. Lumbar spinal fusion using lateral oblique (pre-psoas) approach (Review).
Sovrem Tekhnologii Med 2021;13(5):70-81. https://doi.org/10.17691/stm2021.13.5.09
21. Li R, Li X, Zhou H, Jiang W. Development and application of oblique lumbar interbody fusion. Orthop Surg
2020;12(2):355-65. https://doi.org/10.1111%2Fos.12625
22. Sato J, Ohtori S, Orita S, Yamauchi K, Eguchi Y, Ochiai N, et al. Radiographic evaluation of indirect decompression of mini-open anterior retroperitoneal lumbar interbody fusion: oblique lateral interbody fusion for degenerated lumbar spondylolisthesis. Euro Spine J 2017;26(3):671-8. https://doi.org/10.1007/s00586-015-4170-0
23. Zairi F, Sunna TP, Westwick HJ, Weil AG, Wang Z, Boubez G, et al. Mini-open oblique lumbar interbody fusion
(OLIF) approach for multi-level discectomy and fusion involving L5-S1: Preliminary experience. Orthop Traumatol
Surg Res 2017;103(2):295-9. https://doi.org/10.1016/j.otsr.2016.11.016
24. Julian Li JX, Mobbs RJ, Phan K. Morphometric MRI imaging study of the corridor for the oblique lumbar interbody fusion technique at L1-L5. World Neurosurg 2018;111:e678-e68. https://doi.org/10.1016/j.wneu.2017.12.136
25. Liu L, Liang Y, Zhang H, Wang H, Guo C, Pu X, et al. Imaging anatomical research on the operative windows of
oblique lumbar interbody fusion. PLoS One 2016;11(9):e0163452. https://doi.org/10.1371%2Fjournal.pone.0163452
26. Tao Y, Huang C, Li F, Chen Q. An MRI study of the oblique corridor and the trajectory to the L1–L5 intervertebral discs in the lateral position. World Neurosurg 2020;134:e616-e623. https://doi.org/10.1016/j.wneu.2019.10.147
27. Guérin P, Obeid I, Gille O, Bourghli A, Luc S, Pointillart V, et al. Safe working zones using the minimally invasive lateral retroperitoneal transpsoas approach: a morphometric study. Surg Radiol Anat 2011;33(8):665-71.
https://doi.org/10.1007/s00276-011-0798-6
28. Zhang F, Xu H, Yin B, Tao H, Yang S, Sun C, et al. Does right lateral decubitus position change retroperitoneal
oblique corridor? A radiographic evaluation from L1 to L5. Eur Spine J 2017;26(3):646-50.
https://doi.org/10.1007/s00586-016-4645-7
29. Deukmedjian AR, Le TV, Dakwar E, Martinez CR, Uribe JS. Movement of abdominal structures on magnetic
resonance imaging during positioning changes related to lateral lumbar spine surgery: a morphometric study:
Clinical article. J Neurosurg Spine 2012;16(6):615-23. https://doi.org/10.3171/2012.3.spine1210
30. Wang Z, Liu L, Xu XH, Cao MD, Lu H, Zhang KB. The OLIF working corridor based on magnetic resonance
imaging: a retrospective research. J Orthop Surg Res 2020;15(1):14. https://doi.org/10.1186/s13018-020-01654-1
31. Molinares DM, Davis TT, Fung DA. Retroperitoneal oblique corridor to the L2-S1 intervertebral discs: an MRI
study. J Neurosurg Spine 2016;24(2):248-55. https://doi.org/10.3171/2015.3.spine13976
32. Zehri A, Soriano-Baron H, Peterson KA, Kittel C, Brown PA, Hsu W, et al. Changes in the operative corridor in
oblique lumbar interbody fusion between preoperative magnetic resonance imaging and intraoperative cone-beam computed tomography using morphometric analysis. Cureus 2020;12(6):e8687. https://doi.org/10.7759/cureus.8687
33. Silvestre C, Mac-Thiong JM, Hilmi R, Roussouly P. Complications and morbidities of mini-open anterior
retroperitoneal lumbar interbody fusion: Oblique lumbar interbody fusion in 179 patients. Asian Spine J 2012;6(2):89-97. https://doi.org/10.4184/asj.2012.6.2.89
34. Fujibayashi S, Kawakami N, Asazuma T, Ito M, Mizutani J, Nagashima H, et al. Complications associated with
lateral interbody fusion: Nationwide survey of 2998 cases during the first 2 years of its use in Japan. Spine (Phila Pa 1976) 2017;42(19):1478-84. https://doi.org/10.1097/brs.0000000000002139
35. Abe K, Orita S, Mannoji C, Motegi H, Aramomi M, Ishikawa T, et al. Perioperative complications in 155 patients
who underwent oblique lateral interbody fusion surgery: Perspectives and indications from a retrospective,
multicenter survey. Spine (Phila Pa 1976) 2017;42(1):55-62. https://doi.org/10.1097/brs.0000000000001650
lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) in lumbar spondylolisthesis: a
systematic review and meta-analysis. Spine J 2017;17(11):1712-21. https://doi.org/10.1016/j.spinee.2017.06.018
2. Fenton-White HA. Trailblazing: the historical development of the posterior lumbar interbody fusion (PLIF). Spine J 2021;21(9):1528-41. https://doi.org/10.1016/j.spinee.2021.03.016
3. Lan T, Hu SY, Zhang YT, Zheng YC, Zhang R, Shen Z, et al. Comparison between posterior lumbar interbody
fusion and transforaminal lumbar interbody fusion for the treatment of lumbar degenerative diseases: A systematic review and meta-analysis. World Neurosurg 2018;112:86-93. https://doi.org/10.1016/j.wneu.2018.01.021
4. Meng B, Bunch J, Burton D, Wang J. Lumbar interbody fusion: recent advances in surgical techniques and bone
healing strategies. Eur Spine J 2021;30(1):22-33. https://doi.org/10.1007/s00586-020-06596-0
5. Fleege C, Rickert M, Rauschmann M. PLIF- und TLIF-Verfahren. Indikation, Technik, Vor- und Nachteile [The
PLIF and TLIF techniques. Indication, technique, advantages, and disadvantages]. Orthopade 2015;44(2):114-23.
https://doi.org/10.1007/s00132-014-3065-9
6. Caelers IJMH, de Kunder SL, Rijkers K, van Hemert WLW, de Bie RA, Evers SMAA, et al. Comparison of (partial)
economic evaluations of transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion
(PLIF) in adults with lumbar spondylolisthesis: A systematic review. PLoS One 2021;16(2):e0245963.
https://doi.org/10.1371/journal.pone.0245963
7. Mobbs RJ, Phan K, Malham G, Seex K, Rao PJ. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. J Spine Surg 2015;1(1):2-18. https://doi.org/10.3978/j.issn.2414-469x.2015.10.05
8. Xu DS, Walker CT, Godzik J, Turner JD, Smith W, Uribe JS. Minimally invasive anterior, lateral, and oblique
lumbar interbody fusion: a literature review. Ann Transl Med 2018;6(6):104. https://doi.org/10.21037%2Fatm.2018.03.24
9. Teng I, Han J, Phan K, Mobbs R. A meta-analysis comparing ALIF, PLIF, TLIF and LLIF. J Clin Neurosci 2017;44:11-7. https://doi.org/10.1016/j.jocn.2017.06.013
10. Soriano-Sánchez JA, Baabor-Aqueveque M, Silva-Morales F. Philosophy and concepts of modern spine surgery. Acta Neurochir Suppl 2011;108:23-31. https://doi.org/10.1007/978-3-211-99370-5_5
11. Epstein NE. Review of risks and complications of extreme lateral interbody fusion (XLIF). Surg Neurol Int 2019;10:237. https://doi.org/10.25259/SNI_559_2019
12. Wert WG Jr, Sellers W, Mariner D, Obmann M, Song B, Ryer EJ, et al. Identifying risk factors for complications
during exposure for anterior lumbar interbody fusion. Cureus 2021;13(7):e16792. https://doi.org/10.7759/cureus.16792
13. Piazzolla A, Bizzoca D, Berjano P, Balsano M, Buric J, Carlucci S, et al. Major complications in extreme lateral
interbody fusion access: multicentric study by Italian S.O.L.A.S. group. Eur Spine J 2021;30(1):208-16. https://doi.org/10.1007/s00586-020-06542-0
14. Epstein NE. Incidence of major vascular injuries with extreme lateral interbody fusion (XLIF). Surg Neurol Int
2020;11:70. https://doi.org/10.25259%2FSNI_113_2020
15. Pojskic M, Saβ B, Völlger B, Nimsky C, Carl B. Extreme lateral interbody fusion (XLIF) in a consecutive series of
72 patients. Bosn J Basic Med Sci 2021;21(5):587-97. https://doi.org/10.17305/bjbms.2020.5261
16. Grimm BD, Leas DP, Poletti SC, Johnson DR 2nd. Postoperative complications within the first year after extreme lateral interbody fusion: Experience of the first 108 patients. Clin Spine Surg 2016;29(3):E151-6.
https://doi.org/10.1097/bsd.0000000000000121
17. Mayer HM. A new microsurgical technique for minimally invasive anterior lumbar interbody fusion. Spine (Phila Pa 1976) 1997;22(6):691-9. https://doi.org/10.1097/00007632-199703150-00023
18. Chung HW, Lee HD, Jeon CH, Chung NS. Comparison of surgical outcomes between oblique lateral interbody
fusion (OLIF) and anterior lumbar interbody fusion (ALIF). Clin Neurol Neurosurg 2021;209:106901. https://doi.org/10.1016/j.clineuro.2021.106901
19. Chang MC, Kim GU, Choo YJ, Lee GW. Transforaminal lumbar interbody fusion (TLIF) versus oblique lumbar
interbody fusion (OLIF) in interbody fusion technique for degenerative spondylolisthesis: A systematic review and meta-analysis. Life (Basel) 2021;11(7):696. https://doi.org/10.3390/life11070696
20. Aleinik AY, Mlyavykh SG, Qureshi S. Lumbar spinal fusion using lateral oblique (pre-psoas) approach (Review).
Sovrem Tekhnologii Med 2021;13(5):70-81. https://doi.org/10.17691/stm2021.13.5.09
21. Li R, Li X, Zhou H, Jiang W. Development and application of oblique lumbar interbody fusion. Orthop Surg
2020;12(2):355-65. https://doi.org/10.1111%2Fos.12625
22. Sato J, Ohtori S, Orita S, Yamauchi K, Eguchi Y, Ochiai N, et al. Radiographic evaluation of indirect decompression of mini-open anterior retroperitoneal lumbar interbody fusion: oblique lateral interbody fusion for degenerated lumbar spondylolisthesis. Euro Spine J 2017;26(3):671-8. https://doi.org/10.1007/s00586-015-4170-0
23. Zairi F, Sunna TP, Westwick HJ, Weil AG, Wang Z, Boubez G, et al. Mini-open oblique lumbar interbody fusion
(OLIF) approach for multi-level discectomy and fusion involving L5-S1: Preliminary experience. Orthop Traumatol
Surg Res 2017;103(2):295-9. https://doi.org/10.1016/j.otsr.2016.11.016
24. Julian Li JX, Mobbs RJ, Phan K. Morphometric MRI imaging study of the corridor for the oblique lumbar interbody fusion technique at L1-L5. World Neurosurg 2018;111:e678-e68. https://doi.org/10.1016/j.wneu.2017.12.136
25. Liu L, Liang Y, Zhang H, Wang H, Guo C, Pu X, et al. Imaging anatomical research on the operative windows of
oblique lumbar interbody fusion. PLoS One 2016;11(9):e0163452. https://doi.org/10.1371%2Fjournal.pone.0163452
26. Tao Y, Huang C, Li F, Chen Q. An MRI study of the oblique corridor and the trajectory to the L1–L5 intervertebral discs in the lateral position. World Neurosurg 2020;134:e616-e623. https://doi.org/10.1016/j.wneu.2019.10.147
27. Guérin P, Obeid I, Gille O, Bourghli A, Luc S, Pointillart V, et al. Safe working zones using the minimally invasive lateral retroperitoneal transpsoas approach: a morphometric study. Surg Radiol Anat 2011;33(8):665-71.
https://doi.org/10.1007/s00276-011-0798-6
28. Zhang F, Xu H, Yin B, Tao H, Yang S, Sun C, et al. Does right lateral decubitus position change retroperitoneal
oblique corridor? A radiographic evaluation from L1 to L5. Eur Spine J 2017;26(3):646-50.
https://doi.org/10.1007/s00586-016-4645-7
29. Deukmedjian AR, Le TV, Dakwar E, Martinez CR, Uribe JS. Movement of abdominal structures on magnetic
resonance imaging during positioning changes related to lateral lumbar spine surgery: a morphometric study:
Clinical article. J Neurosurg Spine 2012;16(6):615-23. https://doi.org/10.3171/2012.3.spine1210
30. Wang Z, Liu L, Xu XH, Cao MD, Lu H, Zhang KB. The OLIF working corridor based on magnetic resonance
imaging: a retrospective research. J Orthop Surg Res 2020;15(1):14. https://doi.org/10.1186/s13018-020-01654-1
31. Molinares DM, Davis TT, Fung DA. Retroperitoneal oblique corridor to the L2-S1 intervertebral discs: an MRI
study. J Neurosurg Spine 2016;24(2):248-55. https://doi.org/10.3171/2015.3.spine13976
32. Zehri A, Soriano-Baron H, Peterson KA, Kittel C, Brown PA, Hsu W, et al. Changes in the operative corridor in
oblique lumbar interbody fusion between preoperative magnetic resonance imaging and intraoperative cone-beam computed tomography using morphometric analysis. Cureus 2020;12(6):e8687. https://doi.org/10.7759/cureus.8687
33. Silvestre C, Mac-Thiong JM, Hilmi R, Roussouly P. Complications and morbidities of mini-open anterior
retroperitoneal lumbar interbody fusion: Oblique lumbar interbody fusion in 179 patients. Asian Spine J 2012;6(2):89-97. https://doi.org/10.4184/asj.2012.6.2.89
34. Fujibayashi S, Kawakami N, Asazuma T, Ito M, Mizutani J, Nagashima H, et al. Complications associated with
lateral interbody fusion: Nationwide survey of 2998 cases during the first 2 years of its use in Japan. Spine (Phila Pa 1976) 2017;42(19):1478-84. https://doi.org/10.1097/brs.0000000000002139
35. Abe K, Orita S, Mannoji C, Motegi H, Aramomi M, Ishikawa T, et al. Perioperative complications in 155 patients
who underwent oblique lateral interbody fusion surgery: Perspectives and indications from a retrospective,
multicenter survey. Spine (Phila Pa 1976) 2017;42(1):55-62. https://doi.org/10.1097/brs.0000000000001650