caa a22 4500 445833882 CHVBK 20180317145324.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s00586-010-1609-1 doi (NATIONALLICENCE)springer-10.1007/s00586-010-1609-1 An MRI study of psoas major and abdominal large vessels with respect to the X/DLIF approach [Elektronische Daten] [Wan-Kun Hu, Shi-Sheng He, Shao-Cheng Zhang, Yan-Bin Liu, Ming Li, Tie-Sheng Hou, Xiao-Lu Ma, Jian Wang] Extreme/direct lateral interbody fusion (X/DLIF) has been used to treat various lumbar diseases. However, it involves risks to injure the lumbar plexus and abdominal large vessels when it gains access to the lumbar spine via lateral approach that passes through the retroperitoneal fat and psoas major muscle. This study was aimed to determine the distribution of psoas major and abdominal large vessels at lumbar intervertebral spaces in order to select an appropriate X/DLIF approach to avoid nerve and large vessels injury. Magnetic resonance imaging scanning on lumbar intervertebral spaces was performed in 48 patients (24 males, 24 females, 54.2years on average). According to Moro's method, lumbar intervertebral space was divided into six zones A, I, II, III, IV and P. Thickness of psoas major was measured and distribution of abdominal large vessels was surveyed at each zone. The results show vena cava migrate from the right of zone A to the right of zone I at L1/2-L4/5; abdominal aorta was located mostly to the left of zone A at L1/2-L3/4 and divided into bilateral iliac arteries at L4/5; Psoas major was tenuous and dorsal at L1/2 and L2/3, large and ventral at L3/4 and L4/5. Combined with the distribution of nerve roots reported by Moro, X/DLIF approach is safe via zones II-III at L1/2 and L2/3, and via zone II at L3/4. At L4/5, it is safe via zones I-II in left and via zone II in right side, respectively. Springer-Verlag, 2010 X/DLIF nationallicence Psoas Major nationallicence Abdominal large vessels nationallicence MRI Study nationallicence Hu Wan-Kun Department of Orthopedics, Changhai Hospital, 200433, Shanghai, China aut He Shi-Sheng Department of Orthopedics, Shanghai 10th People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, 200072, Shanghai, China aut Zhang Shao-Cheng Department of Orthopedics, Changhai Hospital, 200433, Shanghai, China aut Liu Yan-Bin Department of Orthopedics, Changhai Hospital, 200433, Shanghai, China aut Li Ming Department of Orthopedics, Changhai Hospital, 200433, Shanghai, China aut Hou Tie-Sheng Department of Orthopedics, Changhai Hospital, 200433, Shanghai, China aut Ma Xiao-Lu Department of Radiology, Changhai Hospital, 200433, Shanghai, China aut Wang Jian Department of Radiology, Changhai Hospital, 200433, Shanghai, China aut European Spine Journal Springer-Verlag 20/4(2011-04-01), 557-562 0940-6719 20:4<557 2011 20 586 https://doi.org/10.1007/s00586-010-1609-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-010-1609-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hu Wan-Kun Department of Orthopedics, Changhai Hospital, 200433, Shanghai, China aut NATIONALLICENCE 700 1- He Shi-Sheng Department of Orthopedics, Shanghai 10th People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, 200072, Shanghai, China aut NATIONALLICENCE 700 1- Zhang Shao-Cheng Department of Orthopedics, Changhai Hospital, 200433, Shanghai, China aut NATIONALLICENCE 700 1- Liu Yan-Bin Department of Orthopedics, Changhai Hospital, 200433, Shanghai, China aut NATIONALLICENCE 700 1- Li Ming Department of Orthopedics, Changhai Hospital, 200433, Shanghai, China aut NATIONALLICENCE 700 1- Hou Tie-Sheng Department of Orthopedics, Changhai Hospital, 200433, Shanghai, China aut NATIONALLICENCE 700 1- Ma Xiao-Lu Department of Radiology, Changhai Hospital, 200433, Shanghai, China aut NATIONALLICENCE 700 1- Wang Jian Department of Radiology, Changhai Hospital, 200433, Shanghai, China aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/4(2011-04-01), 557-562 0940-6719 20:4<557 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer