Awake Lateral Lumbar Fusion

Fig 32.1
Marking the safe entrance point at the lateral position under the CT scanner

Illustrative Case 1

A 57 years old male presented with pain in the low back and leg with intermittent claudication combined. Past medical history was significant for diabetes. At first, his colon was scanned on his left side on the lateral position in the CT room, and the safe entrance point was marked. During the operation, the long needle punctured through L45 intervertebral disc space according to the pre-marked entrance point. After confirmation, the thread was placed. Under the guidance of the guide wire, the thread was expanded step by step, and the appropriate working tube was set up. Then the intervertebral disc was removed; the endplate was stricken off. The autogenetic iliac bone was taken from the spina iliaca posterior superior, and the cage was imbedded. The operation was finished. After 5 years of follow-up, the patient’s symptoms were relieved, and no further treatment was needed.



1 Aorta abdominalis, 2 intervertebral disc entrance point, 3 psoas major, 4 ischiadic nerve, 5 musculus sacrospinalis, 6 retroperitoneal fat, 7 colon descendents



Preoperative MRI


Percutaneous fluoroscopic-guided needle placement


Port placement docked onto the surface of the disc over dilator

Sep 23, 2017 | Posted by in NEUROLOGY | Comments Off on Awake Lateral Lumbar Fusion
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