Fig. 22.1 Sequential tubular dilation (a), docking of expandable retractor (b), intraoperative AP fluoroscopic image with the docked retractor and Cobb elevator in the disk space (c), intraoperative view of…
Fig. 33.1 Anterior view of the retroperitoneal vascular vessels. The aorta artery runs to the left and divides at the L4–L5 intervertebral disc into the two common iliac arteries. The…
Fig. 26.1 Algorithm for supplemental fixation (Adapted from Malham et al. [5]) 26.3.1 Reduced Bone Density Reduced bone density is the main risk factor for subsidence that may result in…
Fig. 17.1 Psoas and iliacus muscles The iliopsoas muscle consists of three distinct muscles: the iliacus, psoas minor, and psoas major. The psoas minor, absent in 40 % of the…
Fig. 36.1 Lumbar plexus from a lateral perspective relevant to the lateral trans-psoas approach [18] Fig. 36.2 Lateral radiograph of the lumbar spine with overlay dividing the vertebral column into…
Epidemiology Patients, n 21 Sex ratio (M/F) 9/12 Mean age, years 47.7 Clinical DDD Pure 12 (57.1 %) Revision 9 (42.9 %) Levela L2–L3 4 (12.1 %) L3–L4 19…
Indications Degenerative disk disease with axial low-back pain Low-grade (Meyerding grade I or II) spondylolithesis Recurrent disk herniation with low-back pain Disk collapse following diskectomy causing foraminal narrowing and secondary…
Fig. 30.1 (a) Preoperative sagittal MRI showing L4–5 spondylolisthesis with stenosis at L3–4, L4–5. (b) Preoperative axial MRI of L3–4 level. Note the lateral recess and foraminal stenosis on the…
Fig. 1.1 Comparison of cage contact area for PLIF, LLIF, and TLIF (Left to right) In an attempt to minimize tissue trauma and improve biomechanical support, an anterolateral retroperitoneal approach…
