Psoas Muscle Management
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…
Lumbar Plexus Injury: Lateral MIS Spinal Fusion
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…
The Extreme Lateral Minimally Invasive Approach to Pure Degenerative Lumbar Disk Disease
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…
Selecting the Proper Patient for Lumbar Lateral Interbody Fusion and Minimally Invasive Spinal Deformity Surgery
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…
Indirect Decompression
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…
History and Rationale for the Minimally Invasive Lateral Approach
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…
Subsidence in LLIF
Fig. 28.1 Early cage subsidence (ECS) described by Malham et al. [9] Fig. 28.2 Three types of subsidence (Adapted from Malham et al. [9]) 28.3 Rates The rate of subsidence…
Techniques for Avoiding Psoas Muscle and Lumbosacral Plexus Injury
Fig. 12.1 (a) Pain drawing of a patient with thigh pain and numbness following a lumbosacral plexus stretch injury with an LLIF surgery; (b) thigh atrophy from an upper lumbar…
Adjacent Level Disease and Proximal Junctional Kyphosis
Fig. 24.1 (a) Intraoperative fluoroscopic images showing retractor placement at the adjacent level disk; (b) lateral fluoroscopic image showing excellent restoration of interbody height using a lateral cage 24.2 Patient…