Critical analysis of extra peritoneal antero-lateral approach for lumbar plexus

Arquivos de Neuro-Psiquiatria

Roberto Sérgio Martins¹  Bernardo Assumpção Monaco²  Mario Gilberto Siqueira¹  Luciano Foroni¹  Carlos Otto Heise¹  Manoel Jacobsen Teixeira² 

[1] ,University of São Paulo Medical School Division of NeurosurgerySão Paulo SP ,Brazil

关键词: lumbar plexus;    surgical approach;    peripheral nerve;    plexo lombar;    acesso cirúrgico;    nervo periférico;   

DOI  :  10.1590/S0004-282X2011000500017

来源: SciELO

【 摘 要 】

Lesions of lumbar plexus are uncommon and descriptions of surgical access are derived from vertebral spine approaches. METHOD: The extraperitoneal anterolateral approach to the lumbar plexus was performed in six adult fresh cadavers. The difficulties on dissection were related. RESULTS: An exposure of all distal elements of lumbar plexus was possible, but a cranial extension of the incision was needed to reach the iliohypogastric nerve in all cases. Ligation of vessels derived from common iliac artery was necessary for genitofemoral and obturator nerves exposure in two cases. The most proximal part of the lumbar roots could be identified only after dissection and clipping of most lumbar vessels. CONCLUSION: The extraperitoneal anterolateral approach allows appropriate exposure of terminal nerves of lumbar plexus laterallly to psoas major muscle. Cranial extension of the cutaneous incision may be necessary for exposure of iliohypogastric nerve. Roots exposure increases the risk of vascular damage.

【 授权许可】

CC BY   
 All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License