Skip to main content

Advertisement

SpringerLink
Log in

Mini-open lateral retroperitoneal lumbar spine approach using psoas muscle retraction technique. Technical report and initial results on six patients

  • Ideas and Technical Innovations
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

The main aim of this paper was to report reproducible method of lumbar spine access via a lateral retroperitoneal route.

Methods

The authors conducted a retrospective analysis of the technical aspects and clinical outcomes of six patients who underwent lateral multilevel retroperitoneal interbody fusion with psoas muscle retraction technique. The main goal was to develop a simple and reproducible technique to avoid injury to the lumbar plexus.

Results

Six patients were operated at 15 levels using psoas muscle retraction technique. All patients reported improvement in back pain and radiculopathy after the surgery. The only procedure-related transient complication was weakness and pain on hip flexion that resolved by the first follow-up visit.

Conclusions

Psoas retraction technique is a reliable technique for lateral access to the lumbar spine and may avoid some of the complications related to traditional minimally invasive transpsoas approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Pimenta L (2001) Lateral endoscopic transpsoas retroperitoneal approach for lumbar spine surgery. VIII Brazilian Spine Society Meeting. Belo Horizonte, Minas Gerais

    Google Scholar 

  2. Youssef JA, McAfee PC, Patty CA, Raley E, DeBauche S, Shucosky E, Chotikul L (2010) Minimally invasive surgery: lateral approach interbody fusion: results and review. Spine (Phila Pa 1976) 35:S302–S311. doi:10.1097/BRS.0b013e3182023438

    Article  Google Scholar 

  3. Guerin P, Obeid I, Bourghli A, Masquefa T, Luc S, Gille O, Pointillart V, Vital JM (2012) The lumbosacral plexus: anatomic considerations for minimally invasive retroperitoneal transpsoas approach. Surg Radiol Anat 34:151–157. doi:10.1007/s00276-011-0881-z

    Article  PubMed  Google Scholar 

  4. Moro T, Kikuchi S, Konno S, Yaginuma H (2003) An anatomic study of the lumbar plexus with respect to retroperitoneal endoscopic surgery. Spine (Phila Pa 1976) 28:423–428. doi:10.1097/01.BRS.0000049226.87064.3B discussion 427–428

    Google Scholar 

  5. Samudrala S, Khoo LT, Rhim SC, Fessler RG (1999) Complications during anterior surgery of the lumbar spine: an anatomically based study and review. Neurosurg Foc 7:e9. doi:10.3171/foc.1999.7.6.10

    CAS  Google Scholar 

  6. Knight RQ, Schwaegler P, Hanscom D, Roh J (2009) Direct lateral lumbar interbody fusion for degenerative conditions: early complication profile. J Spin Disord Tech 22:34–37. doi:10.1097/BSD.0b013e3181679b8a

    Article  Google Scholar 

  7. Banagan K, Gelb D, Poelstra K, Ludwig S (2011) Anatomic mapping of lumbar nerve roots during a direct lateral transpsoas approach to the spine: a cadaveric study. Spine (Phila Pa 1976) 36:E687–E691. doi:10.1097/BRS.0b013e3181ec5911

    Article  Google Scholar 

  8. Smith WD, Christian G, Serrano S, Malone KT (2012) A comparison of perioperative charges and outcome between open and mini-open approaches for anterior lumbar discectomy and fusion. J Clin Neurosci Off J Neurosurg Soc Australasia 19:673–680. doi:10.1016/j.jocn.2011.09.010

    Google Scholar 

  9. Mehren C, Korge A, Siepe C, Grochulla F, Mayer HM (2010) Minimal invasive anterior midline approach to L2–L5. Opera Orthopadie und Traumatologie 22:573–581. doi:10.1007/s00064-010-8053-6

    Article  Google Scholar 

  10. Kim JS, Choi WG, Lee SH (2010) Minimally invasive anterior lumbar interbody fusion followed by percutaneous pedicle screw fixation for isthmic spondylolisthesis: minimum 5-year follow-up. Spine J 10:404–409. doi:10.1016/j.spinee.2010.02.022

    Article  PubMed  Google Scholar 

  11. Aebi M, Parthasarathy S, Avadhani A, Rajasekaran S (2010) Minimal invasive anterior lumbar interbody fusion (mini ALIF). Eur Spine J 19:335–336. doi:10.1007/s00586-010-1300-6

    Article  PubMed  Google Scholar 

  12. Kim JS, Lee KY, Lee SH, Lee HY (2010) Which lumbar interbody fusion technique is better in terms of level for the treatment of unstable isthmic spondylolisthesis? J Neurosurg Spine 12:171–177. doi:10.3171/2009.9.SPINE09272

    Article  PubMed  Google Scholar 

  13. Kim JS, Kang BU, Lee SH, Jung B, Choi YG, Jeon SH, Lee HY (2009) Mini-transforaminal lumbar interbody fusion versus anterior lumbar interbody fusion augmented by percutaneous pedicle screw fixation: a comparison of surgical outcomes in adult low-grade isthmic spondylolisthesis. J Spinal Disord Tech 22:114–121. doi:10.1097/BSD.0b013e318169bff5

    Article  PubMed  Google Scholar 

  14. Lee SH, Choi WG, Lim SR, Kang HY, Shin SW (2004) Minimally invasive anterior lumbar interbody fusion followed by percutaneous pedicle screw fixation for isthmic spondylolisthesis. Spine J 4:644–649. doi:10.1016/j.spinee.2004.04.012

    Article  PubMed  Google Scholar 

  15. Brau SA (2002) Mini-open approach to the spine for anterior lumbar interbody fusion: description of the procedure, results and complications. Spine J 2:216–223

    Article  PubMed  Google Scholar 

  16. Chung SK, Lee SH, Lim SR, Kim DY, Jang JS, Nam KS, Lee HY (2003) Comparative study of laparoscopic L5–S1 fusion versus open mini-ALIF, with a minimum 2-year follow-up. Eur Spine J 12:613–617. doi:10.1007/s00586-003-0526-y

    Article  PubMed  Google Scholar 

  17. Zdeblick TA, David SM (2000) A prospective comparison of surgical approach for anterior L4–L5 fusion: laparoscopic versus mini anterior lumbar interbody fusion. Spine (Phila Pa 1976) 25:2682–2687

    Article  CAS  Google Scholar 

  18. Kaiser MG, Haid RW Jr, Subach BR, Miller JS, Smith CD, Rodts GE Jr (2002) Comparison of the mini-open versus laparoscopic approach for anterior lumbar interbody fusion: a retrospective review. Neurosurgery 51:97–103 discussion 103–105

    Article  PubMed  Google Scholar 

  19. Wolf O, Meier U (1999) First experiences using microsurgical techniques for minimally invasive ventral interbody fusion of the lumbar spine (MINI-ALIF). Zeitschrift fur arztliche Fortbildung und Qualitatssicherung 93:267–271

    PubMed  CAS  Google Scholar 

  20. Sharma AK, Kepler CK, Girardi FP, Cammisa FP, Huang RC, Sama AA (2011) Lateral lumbar interbody fusion: clinical and radiographic outcomes at 1 year: a preliminary report. J Spinal Disord Tech 24:242–250. doi:10.1097/BSD.0b013e3181ecf995

    Article  PubMed  Google Scholar 

  21. Rodgers WB, Gerber EJ, Patterson J (2011) Intraoperative and early postoperative complications in extreme lateral interbody fusion: an analysis of 600 cases. Spine (Phila Pa 1976) 36:26–32. doi:10.1097/BRS.0b013e3181e1040a

    Article  Google Scholar 

  22. Kasliwal MK, Deutsch H (2011) Anhidrosis after anterior retroperitoneal approach for L4–L5 artificial disc replacement. J Clin Neurosci 18:990–991. doi:10.1016/j.jocn.2010.11.022

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Morsani College of Medicine, University of South Florida, 12902 Magnolia Drive, Tampa, FL, USA

    Kamran Aghayev & Frank D. Vrionis

  2. Department of Neurosurgery and Orthopedics, Morsani College of Medicine, University of South Florida, Tampa, FL, USA

    Kamran Aghayev & Frank D. Vrionis

Authors
  1. Kamran Aghayev
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Frank D. Vrionis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kamran Aghayev.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material (MPG 63160 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Aghayev, K., Vrionis, F.D. Mini-open lateral retroperitoneal lumbar spine approach using psoas muscle retraction technique. Technical report and initial results on six patients. Eur Spine J 22, 2113–2119 (2013). https://doi.org/10.1007/s00586-013-2931-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-013-2931-1

Keywords

Search

Navigation