Meng Yuxin, Gao Shangju, Meng Fantao, Li Wenyi, Niu Yanwang, Wei Jingchao
Hebei North University, Zhangjiakou, Hebei, China.
Department of Orthopedics, Hebei General Hospital, Shijiazhuang, Hebei, China.
Front Surg. 2025 Aug 20;12:1621533. doi: 10.3389/fsurg.2025.1621533. eCollection 2025.
Oblique lumbar interbody fusion (OLIF) is a minimally invasive technique for the treatment of degenerative diseases of the lumbar spine, and the left operative window is always used to avoid the inferior vena cava (IVC). However, in cases with anatomical variations-particularly vascular anomalies, which most significantly impact surgical approaches-the right retroperitoneal approach may serve as a preferable alternative. This case report describes a 59-year-old man with lumbar instability and a rare left-sided IVC who underwent OLIF via a right approach. Preoperative imaging of this patient showed an isolated left IVC. The procedure was performed through a right-sided surgical corridor bounded medially by the abdominal aorta(AA) and laterally by the right psoas major muscle. The approach was supplemented with lateral screw-rod instrumentation to maintain stability. The patient's neurological function improved significantly after surgery, and the surgical approach proved to be feasible while maintaining biomechanical stability while avoiding vascular risk. This case highlights the importance of vascular evaluation before OLIF. Especially for the rare left-sided IVC, OLIF via right approach can effectively improve safety.
斜外侧腰椎椎间融合术（OLIF）是一种用于治疗腰椎退行性疾病的微创技术，通常采用左侧手术入路以避开下腔静脉（IVC）。然而，在存在解剖变异的情况下，尤其是血管异常，这对手术入路影响最为显著，右侧腹膜后入路可能是更好的选择。本病例报告描述了一名59岁腰椎不稳且伴有罕见左侧下腔静脉的男性患者，他接受了经右侧入路的OLIF手术。该患者术前影像学检查显示为孤立性左侧下腔静脉。手术通过右侧手术通道进行，内侧以腹主动脉（AA）为界，外侧以右侧腰大肌为界。该入路辅以侧方螺钉棒内固定以维持稳定性。术后患者神经功能明显改善，该手术入路在避免血管风险的同时维持生物力学稳定性，证明是可行的。本病例强调了OLIF术前血管评估的重要性。特别是对于罕见的左侧下腔静脉，经右侧入路的OLIF可有效提高安全性。
