Morphometric MRI imaging study of the corridor for the Oblique Lumbar Interbody Fusion (OLIF) technique at L1-L5.

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Morphometric MRI imaging study of the corridor for the Oblique Lumbar Interbody Fusion (OLIF) technique at L1-L5.

World Neurosurg. 2017 Dec 30;:

Authors: Julian Li JX, Mobbs R, Phan K

Abstract
BACKGROUND: Anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF/XLIF) are associated with approach-related disadvantages. Oblique lumbar interbody fusion (OLIF) is the proposed solution especially for upper lumbar levels. We analysed the size and regional anatomy of the corridor used in the oblique lumbar interbody fusion (OLIF) technique between levels L1 and L5.
METHODS: This is a morphometric study of 200 randomly selected MRI studies with features of lumbar degenerative disease. On MR imaging, the oblique corridor was defined as the smallest distance between the psoas major muscle and aorta/inferior vena cava (or common iliac artery) and measured at the L1/L2, L2/L3, L3/L4 and L4/L5 disc levels on both the left and right on the axial image at the mid-disc level.
RESULTS: Mean distances of the oblique corridor on the left were L1/L2=18.90mm, L2/L3=15.50mm; L3/L4=12.75mm and L4/L5=8.92mm, and on the right were L1/L2=14.80mm, L2/L3=5.50mm, L3/L4=3.00mm and L4/L5=1.46mm. For both sides, the corridor size was not significantly affected by sex, increased with age and decreased at the inferior lumbar disc levels. The L1/L2 and L2/L3 levels may be obstructed by the ipsilateral kidney and renal vasculature on both sides, and the liver on the right.
CONCLUSIONS: A left-sided OLIF approach is viable for both sexes. Oblique access to the L1/L2 and L2/L3 disc levels is feasible regardless of age, while the L3/L4 and L4/L5 levels may be more suitable in the elderly, especially for males. The right-sided approach less likely to be effectively performed.

PMID: 29294391 [PubMed - as supplied by publisher]

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