Imaging Anatomical Research on the Operative Windows of Oblique Lumbar Interbody Fusion.
To provide applied anatomical evidence of the preoperative assessment of oblique lumbar interbody fusion (OLIF), the anatomical parameters of the OLIF operative window were observed through computed tomography angiography (CTA). We selected imaging data from 60 adults (30 males, 30 females) who underwent abdominal CTA and T12-S1 vertebral computed tomography (CT) with three-dimensional reconstruction. The OLIF operative windows at the L1-2, L2-3, L3-4, L4-5 and L5-S1 levels were as follows: the vascular window, bare window, psoas major window, ideal operative window, and actual operative window. Each level's actual operative window was statistically analyzed based on an actual operative window of <1 cm and ≥1 cm. The vascular window was largest at L4-5 (1.72 ± 0.58 cm). The bare window was largest at L5-S1 (1.59 ± 0.93 cm) and smallest at L3-4 (1.37 ± 0.51 cm). The psoas major window was largest at L3-4 (1.14 ± 0.35 cm) and smallest at L1-2 (0.41 ± 0.34 cm). The ideal operative window was largest at L4-5 (3.74 ± 0.36 cm) and smallest at L1-2 (3.23 ± 0.30 cm). The actual operative window was largest at L3-4, followed by L2-3, L4-5, L1-2, and L5-S1, which were 2.51 ± 0.56 cm, 2.28 ± 0.54 cm, 2.01 ± 0.74 cm, 1.80 ± 0.45 cm and 1.59 ± 0.93 cm, respectively (P = 0.000), and the percentages of the actual surgical window were 69%, 66%, 53%, 56% and 43%, respectively. The actual surgical window was <1 cm in 2 cases at L1-2 (3.3%), 4 cases at L4-5 (6.7%), and 17 cases at L5-S1 (28.3%) (11 males and 6 females). The regional anatomy of each level related to OLIF has its own peculiarities, and not all levels are suitable for OLIF. Before OLIF surgery, surgeons should analyze the imaging anatomy and select the appropriate surgical procedures.
Department of Orthopedics, Chongqing No. 13 People's Hospital, Chongqing, China.|Department of Orthopedics, Orthopedics Center of PLA, Southwest Hospital, Third Military Medical University, Chongqing, China.
Liehua
http://orcid.org/0000-0002-3915-8759
L
Liu
Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
Yong
Y
Liang
Department 5, Chongqing Psychiatric Hospital, Chongqing, China.
Hong
H
Zhang
Department of Orthopedics, Orthopedics Center of PLA, Southwest Hospital, Third Military Medical University, Chongqing, China.
Haoming
H
Wang
Department of Orthopedics, Orthopedics Center of PLA, Southwest Hospital, Third Military Medical University, Chongqing, China.
Congtao
C
Guo
Department of Orthopedics, Orthopedics Center of PLA, Southwest Hospital, Third Military Medical University, Chongqing, China.
Xiaobing
X
Pu
Department of Orthopedics, Orthopedics Center of PLA, Southwest Hospital, Third Military Medical University, Chongqing, China.
Chengmin
C
Zhang
Department of Orthopedics, Orthopedics Center of PLA, Southwest Hospital, Third Military Medical University, Chongqing, China.
Liyuan
L
Wang
Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
Jian
J
Wang
Department of Orthopedics, Chongqing No. 13 People's Hospital, Chongqing, China.
Yingwen
Y
Lv
Department of Orthopedics, Chongqing No. 13 People's Hospital, Chongqing, China.
Zhoukui
Z
Ren
Department of Orthopedics, Orthopedics Center of PLA, Southwest Hospital, Third Military Medical University, Chongqing, China.
Qiang
Q
Zhou
Department of Orthopedics, 2nd Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Zhongliang
Z
Deng
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