ArticleInternational journal of spine surgery2023
Comparison of Nonneurological Structures at Risk During Anterior-to-Psoas Versus Transpsoas Surgical Approaches Using Abdominal CT Imaging From L1 to S1.
Article in International journal of spine surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe kidneys, ribs, liver, spleen, and iliac crests can pose access-related issues to the disc space during both anterior-to-psoas (ATP) and transpsoas (TP) surgical approaches. The aim of this study was to identify and compare the presence and degree of obstruction caused by these structures for the ATP and TP approaches bilaterally from L1 to S1 using abdominal computed tomography.
methodsPresence of obstruction by a given structure was recorded if the structure was within ATP or TP borders. Degree of obstruction was calculated as the quotient of the structure measurement within the ATP or TP approach divided by the entire corridor length at the point of obstruction.
resultsThe percentage of time the left kidney was present during the ATP vs TP approaches at L1 to L2 was 44% vs 89% (
conclusionsThis study is the first to both characterize and compare nonneurological structures at risk during ATP and TP fusion approaches bilaterally from L1 to S1 using abdominal computed tomography. Findings suggest the ATP approach poses less structures at risk relative to the TP approach with respect to the kidneys, ribs, and iliac crests bilaterally. The TP approach offers advantages compared with ATP approach with respect to the liver and spleen. CLINICAL RELEVANCE: Findings from this study are clinically relevant for ATP and TP surgical approach planning. LEVEL OF EVIDENCE: 3:
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