Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Department of Orthopedics, Foshan First People's Hospital, Foshan, China.
Clin Anat. 2022 Mar;35(2):178-185. doi: 10.1002/ca.23804. Epub 2021 Nov 18.
To evaluate the operating range and morphology of the surgical safe zone for oblique lumbar interbody fusion (OLIF). Twenty embalmed full-torso cadaveric specimens were dissected. The oblique corridor and the distance between adjacent lumbar arteries were measured in a static state and with psoas major retraction. The morphology and size of the safe zone for OLIF and the location of the lumbar sympathetic trunk were also recorded. The oblique corridor of the L1-L5 segments was significantly greater in the retracted state than in the static state (p < 0.05). With psoas major retraction, the distances between adjacent lumbar arteries at L1-4 were significantly greater (p < 0.05) than those in the static state. The lumbar sympathetic trunk is just located in the safe zone and travels downward adjacent to the psoas major. The shape of the safe zone for OLIF was approximately an oblique upward parallelogram at L1/2 and L2/3, an isosceles trapezoid at L3/4, and an irregular quadrangle or triangle at L4/5. The safe zone for OLIF at L1/2, L2/3, and L3/4 was significantly larger during retraction than in the static state (p < 0.05). On the lateral side of the lumbar spine there is a natural surgical safe zone for OLIF, which can provide a sufficient operating space. The safe zone has a certain morphological pattern in L1-5 segments and psoas major retraction can significantly enlarge it.
评估斜侧腰椎间融合术（OLIF）手术安全区的操作范围和形态。对 20 具防腐全尸体标本进行解剖。在静态和腰大肌牵开状态下测量斜行通道和相邻腰椎动脉之间的距离。记录 OLIF 手术安全区的形态和大小以及腰椎交感干的位置。L1-L5 节段的斜行通道在牵开状态下明显大于静态状态（p<0.05）。在腰大肌牵开时，L1-4 相邻腰椎动脉之间的距离明显大于静态状态（p<0.05）。腰椎交感干刚好位于安全区内，沿腰大肌向下走行。OLIF 手术安全区的形状在 L1/2 和 L2/3 处近似斜向上的平行四边形，在 L3/4 处为等腰梯形，在 L4/5 处为不规则四边形或三角形。OLIF 手术安全区在 L1/2、L2/3 和 L3/4 在牵开时明显大于静态状态（p<0.05）。在腰椎侧方存在自然的 OLIF 手术安全区，可以提供足够的操作空间。安全区在 L1-5 节段具有一定的形态模式，腰大肌牵开可以显著扩大其范围。
