Neutral hip position for the oblique lumbar interbody fusion (OLIF) approach increases the retroperitoneal oblique corridor

BMC Musculoskeletal Disorders

Worawat Limthongkul¹  Wicharn Yingsakmongkol¹  Weerasak Singhatanadgige¹  Vit Kotheeranurak²  Chindarat Ratanakornphan³  Richard A. Hynes⁴ 

[1] Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Rd, Pathumwan, 10330, Bangkok, Thailand;Department of Orthopedics, Queen Savang Vadhana Memorial Hospital, Chonburi, Sriracha, Thailand;Radiology Department, King Chulalongkorn Memorial Hospital, Bangkok, Thailand;The B.A.C.K. Center, Florida, Melbourne, USA;

关键词: Retroperitoneal oblique corridor;    ROC;    Oblique lateral lumbar interbody fusion;    OLIF;    Hip position;    MRI;   

DOI  :  10.1186/s12891-020-03592-9

来源: Springer

【 摘 要 】

BackgroundThe prepsoas lateral approach for spinal fusion, oblique lateral lumbar interbody fusion (OLIF), is considered one of the minimally invasive spinal fusion methods and is gaining popularity due to improved outcomes with copious supporting evidence. To date, no publication has studied the various positions of the left hip in actual patients which might affect the retroperitoneal oblique corridor (ROC). The study aimed to find the relevancy of the left hip position and the size of ROC.MethodsWe recruited 40 consecutive patients who needed diagnostic MRI from the out-patient clinic. MRI scan from L2 to L5 was performed in the supine, right lateral decubitus with hip flexion, and right lateral decubitus with hip in a neutral position. The retroperitoneal oblique corridor (ROC) was measured at the intervertebral disc level and compared.ResultsROC of the hip in neutral position was significantly larger than hip flexion in all levels (p < 0.05); there was no significant difference in the ROC among levels (p = 0.22). ROC seems to be largest at L2/3 followed by L3/4 and L4/5 respectively in all positions.ConclusionsThe retroperitoneal oblique corridors of L2 to L5 were significantly increased when the hip is in the neutral position, while the psoas cross-sectional area and anterior thickness were minimized in this position. Surgeons might benefit from a neutral position of the left hip in the oblique lateral lumbar interbody fusion (OLIF) procedure.

【 授权许可】

CC BY