ArticleSpine surgery and related research2021
Localization of the Lumbar Plexus in the Psoas Muscle: Considerations for Avoiding Lumbar Plexus Injury during the Transpsoas Approach.
Article in Spine surgery and related research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed, 14 citations in OpenAlex.
- Elimination of Lumbar Plexus Injury by Changing the Entry Point and Traction Direction of the Psoas Major Muscle in Transpsoas Lateral Lumbar Spine Surgery.Medicina (Kaunas, Lithuania) · 2023Article
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10 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionTranspsoas lumbar spine surgery is minimally invasive and has very good corrective effects. However, approach-side nerve complications delay post-operative rehabilitation. We anatomically investigated the localization of the lumbar plexus running in the psoas muscle.
methodsWe examined 27 formalin-fixed cadavers. The left-sided psoas muscle was extracted and cut parallel to the intervertebral disc at the L2/3, L3/4, and L4/5 disc levels. Using digitized photographs, we calculated the ratio of the distance from the front edge of the psoas muscle to the center of the lumbar plexus in the anteroposterior diameter of the psoas muscle (%). Then, we calculated the ratio of the distance from the lateral edge of the psoas muscle to the center of the lumbar plexus in the lateral diameter of the psoas muscle (%).
resultsThe anterior-posterior lumbar plexus localization was 74.5 at L2/3, 74.7 at L3/4, and 81.2 at L4/5. There was a significant difference between L2/3 and L4/5 and between L3/4 and L4/5, but not between L2/3 and L3/4 (P=0.02, 0.01, and 0.94, respectively). The lateral and medial lumbar plexus localization was 85.4 at L2/3, 83.9 at L3/4, and 77.7 at L4/5. There was a significant difference between L2/3 and L4/5 and between L3/4 and L4/5, but not between L2/3 and L3/4 (P=0.01, 0.04, and 0.41, respectively).
conclusionsThe lumbar plexus was localized in the posterior one-third and medial one-third of the psoas muscle and moved to a posterolateral location at L4/5. To avoid neuropathy, consider the psoas muscle's position relative to that of the intervertebral disc. It is essential to understand lumbar plexus localization in the psoas muscle when looking directly at this muscle to enter the pricking point or route with a lower risk of nerve damage.
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