Elimination of Lumbar Plexus Injury by Changing the Entry Point and Traction Direction of the Psoas Major Muscle in Transpsoas Lateral Lumbar Spine Surgery
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
4.1. Indication for Surgery and Patient Selection
4.2. Direct and Indirect Nerve Damage
4.3. Surgical Indication Criteria and Modified Surgical Approach
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Silvestre, C.; Mac-Thiong, J.M.; 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, 89–97. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Gragnaniello, C.; Seex, K. Anterior to psoas (ATP) fusion of the lumbar spine: Evolution of a technique facilitated by changes in equipment. J. Spine Surg. 2016, 2, 256–265. [Google Scholar] [CrossRef] [PubMed]
- Ozgur, B.M.; Aryan, H.E.; Pimenta, L.; Taylor, W.R. Extreme Lateral Interbody Fusion (XLIF): A novel surgical technique for anterior lumbar interbody fusion. Spine J. 2006, 6, 435–443. [Google Scholar] [CrossRef] [PubMed]
- Fujibayashi, S.; Kawakami, N.; Asazuma, T.; Ito, M.; Mizutani, J.; Nagashima, H.; Nakamura, M.; Sairyo, K.; Takemasa, R.; Iwasaki, M. Complications Associated With Lateral Interbody Fusion: Nationwide Survey of 2998 Cases during the First 2 Years of Its Use in Japan. Spine 2017, 42, 1478–1484. [Google Scholar] [PubMed]
- Walker, C.T.; Farber, S.H.; Cole, T.S.; Xu, D.S.; Godzik, J.; Whiting, A.C.; Hartman, C.; Porter, R.W.; Turner, J.D.; Uribe, J. Complications for minimally invasive lateral interbody arthrodesis: A systematic review and meta-analysis comparing prepsoas and transpsoas approaches. J. Neurosurg. Spine 2019, 30, 446–460. [Google Scholar]
- Ahmadian, A.; Deukmedjian, A.R.; Abel, N.; Dakwar, E.; Uribe, J.S. Analysis of lumbar plexopathies and nerve injury after lateral retroperitoneal transpsoas approach: Diagnostic standardization. J. Neurosurg. Spine 2013, 18, 289–297. [Google Scholar] [PubMed] [Green Version]
- Hah, R.; Kang, H.P. Lateral and Oblique Lumbar Interbody Fusion-Current Concepts and a Review of Recent Literature. Curr. Rev. Musculoskelet. Med. 2019, 12, 305–310. [Google Scholar] [PubMed]
- Li, J.X.; Phan, K.; Mobbs, R. Oblique Lumbar Interbody Fusion: Technical Aspects, Operative Outcomes, and Complications. World Neurosurg. 2017, 98, 113–123. [Google Scholar] [CrossRef] [PubMed]
- Cummock, M.D.; Vanni, S.; Levi, A.D.; Yu, Y.; Wang, M.Y. An analysis of postoperative thigh symptoms after minimally invasive transpsoas lumbar interbody fusion. J. Neurosurg. Spine 2011, 15, 11–18. [Google Scholar] [PubMed]
- Salzmann, S.N.; Shirahata, T.; Okano, I.; Winter, F.; Sax, O.C.; Yang, J.; Shue, J.; Sama, A.A.; Cammisa, F.P.; Girardi, F.P.; et al. Does L4-L5 Pose Additional Neurologic Risk in Lateral Lumbar Interbody Fusion? World Neurosurg. 2019, 129, e337–e342. [Google Scholar] [CrossRef]
- Ohiorhenuan, I.E.; Martirosyan, N.L.; Wewel, J.T.; Sagar, S.; Uribe, J.S. Lateral Interbody Fusion at L4/5: Management of the Transitional Psoas. World Neurosurg. 2021, 148, e192–e196. [Google Scholar] [CrossRef]
- Nojiri, H.; Okuda, T.; Miyagawa, K.; Kobayashi, N.; Sato, T.; Hara, T.; Ohara, Y.; Kudo, H.; Sakai, T.; Kaneko, K. Localization of the Lumbar Plexus in the Psoas Muscle: Considerations for Avoiding Lumbar Plexus Injury during the Transpsoas Approach. Spine Surg. Relat. Res. 2021, 5, 86–90. [Google Scholar] [PubMed]
- Keorochana, G.; Setrkraising, K.; Woratanarat, P.; Arirachakaran, A.; Kongtharvonskul, J. Clinical outcomes after minimally invasive transforaminal lumbar interbody fusion and lateral lumbar interbody fusion for treatment of degenerative lumbar disease: A systematic review and meta-analysis. Neurosurg. Rev. 2018, 41, 755–770. [Google Scholar] [CrossRef]
- Voyadzis, J.M.; Felbaum, D.; Rhee, J. The rising psoas sign: An analysis of preoperative imaging characteristics of aborted minimally invasive lateral interbody fusions at L4-5. J. Neurosurg. Spine 2014, 20, 531–537. [Google Scholar] [CrossRef]
- Fourman, M.S.; Alluri, R.K.; Sarmiento, J.M.; Lyons, K.; Lovecchio, F.; Araghi, K.; Dalal, S.; Shinn, D.; Song, J.; Shahi, P.; et al. Female Sex and Supine Proximal Lumbar Lordosis are Associated with the Size of the LLIF “Safe Zone” at L4-5. Spine 2022, 22, S35–S36. [Google Scholar] [CrossRef]
- Oyekan, A.; Dalton, J.; Fourman, M.S.; Ridolfi, D.; Cluts, L.; Couch, B.; Shaw, J.D.; Donaldson, W.; Lee, J.Y. Multilevel tandem spondylolisthesis associated with a reduced “safe zone” for a transpsoas lateral lumbar interbody fusion at L4-5. Neurosurg. Focus. 2023, 54, E5. [Google Scholar]
- Pumberger, M.; Hughes, A.P.; Huang, R.R.; Sama, A.A.; Cammisa, F.P.; Girardi, F.P. Neurologic deficit following lateral lumbar interbody fusion. Eur. Spine J. 2012, 21, 1192–1199. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Isaacs, R.E.; Hyde, J.; Goodrich, J.A.; Rodgers, W.B.; Phillips, F.M. A prospective, nonrandomized, multicenter evaluation of extreme lateral interbody fusion for the treatment of adult degenerative scoliosis: Perioperative outcomes and complications. Spine 2010, 35 (Suppl. S26), S322–S330. [Google Scholar] [CrossRef] [PubMed]
- Silverstein, J.W.; Block, J.; Smith, M.L.; Bomback, D.A.; Sanderson, S.; Paul, J.; Ball, H.; Ellis, J.A.; Goldstein, M.; Kramer, D.L.; et al. Femoral nerve neuromonitoring for lateral lumbar interbody fusion surgery. Spine J. 2022, 22, 296–304. [Google Scholar]
- Tohmeh, A.G.; Rodgers, W.B.; Peterson, M.D. Dynamically evoked, discrete-threshold electromyography in the extreme lateral interbody fusion approach. J. Neurosurg. Spine 2011, 14, 31–37. [Google Scholar]
- Shirahata, T.; Okano, I.; Salzmann, S.N.; Sax, O.C.; Shue, J.; Sama, A.A.; Cammisa, F.P.; Toyone, T.; Inagaki, K.; Hughes, A.P.; et al. Association Between Surgical Level and Early Postoperative Thigh Symptoms among Patients Undergoing Standalone Lateral Lumbar Interbody Fusion. World Neurosurg. 2020, 134, e885–e891. [Google Scholar] [CrossRef] [PubMed]
Group X (n = 50) | Group A (n = 50) | p-Value | |
---|---|---|---|
Age (years) | 71.8 ± 10.2 | 70.4 ± 12.1 | N.S. |
Sex (male/female) | M13/F37 | M10/F40 | N.S. |
Body mass index | 25.6 ± 3.8 | 24.3 ± 3.1 | N.S. |
Approach (right/left) | R3/L47 | R2/L48 | N.S. |
Relative position value (%) | 38.8 ± 16.2 | 42.1 ± 20.1 | N.S. |
Group X (n = 50) | Group A (n = 50) | p-Value | |
---|---|---|---|
Estimated blood loss (g) | 29.9 ± 18.9 | 27.0 ± 20.2 | N.S. |
Duration of surgery (min) | 142.3 ± 30.8 | 133.7 ± 25.9 | N.S. |
Intraoperative neuromonitoring stimulation threshold (mA) | 13.1 ± 5.4 | 18.5 ± 2.3 | <0.001 |
Warning signals | 20 (40.0%) | 0 (0%) | <0.001 |
Nerve injury | 5 (10.0%) | 0 (0%) | <0.05 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Nojiri, H.; Okuda, T.; Takano, H.; Gomi, M.; Takahashi, R.; Shimura, A.; Tamagawa, S.; Hara, T.; Ohara, Y.; Ishijima, M. Elimination of Lumbar Plexus Injury by Changing the Entry Point and Traction Direction of the Psoas Major Muscle in Transpsoas Lateral Lumbar Spine Surgery. Medicina 2023, 59, 730. https://doi.org/10.3390/medicina59040730
Nojiri H, Okuda T, Takano H, Gomi M, Takahashi R, Shimura A, Tamagawa S, Hara T, Ohara Y, Ishijima M. Elimination of Lumbar Plexus Injury by Changing the Entry Point and Traction Direction of the Psoas Major Muscle in Transpsoas Lateral Lumbar Spine Surgery. Medicina. 2023; 59(4):730. https://doi.org/10.3390/medicina59040730
Chicago/Turabian StyleNojiri, Hidetoshi, Takatoshi Okuda, Hiromitsu Takano, Motoshi Gomi, Ryosuke Takahashi, Arihisa Shimura, Shota Tamagawa, Takeshi Hara, Yukoh Ohara, and Muneaki Ishijima. 2023. "Elimination of Lumbar Plexus Injury by Changing the Entry Point and Traction Direction of the Psoas Major Muscle in Transpsoas Lateral Lumbar Spine Surgery" Medicina 59, no. 4: 730. https://doi.org/10.3390/medicina59040730