Tags

Type your tag names separated by a space and hit enter

Clinical anatomy and 3D virtual reconstruction of the lumbar plexus with respect to lumbar surgery.
BMC Musculoskelet Disord. 2011 Apr 14; 12:76.BM

Abstract

BACKGROUND

Exposure of the anterior or lateral lumbar via the retroperitoneal approach easily causes injuries to the lumbar plexus. Lumbar plexus injuries which occur during anterior or transpsoas lumbar spine exposure and placement of instruments have been reported. This study aims is to provide more anatomical data and surgical landmarks in operations concerning the lumbar plexus in order to prevent lumbar plexus injuries and to increase the possibility of safety in anterior approach lumbar surgery.

METHODS

To study the applied anatomy related to the lumbar plexus of fifteen formaldehyde-preserved cadavers, Five sets of Virtual Human (VH) data set were prepared and used in the study. Three-dimensional (3D) computerized reconstructions of the lumbar plexus and their adjacent structures were conducted from the VH female data set.

RESULTS

The order of lumbar nerves is regular. From the anterior view, lumbar plexus nerves are arranged from medial at L5 to lateral at L2. From the lateral view, lumbar nerves are arranged from ventral at L2 to dorsal at L5. The angle of each nerve root exiting outward to the corresponding intervertebral foramen increases from L1 to L5. The lumbar plexus nerves are observed to be in close contact with transverse processes (TP). All parts of the lumbar plexus were located by sectional anatomy in the dorsal third of the psoas muscle. Thus, access to the psoas major muscle at the ventral 2/3 region can safely prevent nerve injuries. 3D reconstruction of the lumbar plexus based on VCH data can clearly show the relationships between the lumbar plexus and the blood vessels, vertebral body, kidney, and psoas muscle.

CONCLUSION

The psoas muscle can be considered as a surgical landmark since incision at the ventral 2/3 of the region can prevent lumbar plexus injuries for procedures requiring exposure of the lateral anterior of the lumbar. The transverse process can be considered as a landmark and reference in surgical operations by its relative position to the lumbar plexus. 3D reconstructions of the lumbar plexus based on VCH data provide a virtual morphological basis for anterior lumbar surgery.

Authors+Show Affiliations

Department of Orthopedics, Kunming General Hospital, Chengdu Military Region, PLA, Kunming, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21492461

Citation

Lu, Sheng, et al. "Clinical Anatomy and 3D Virtual Reconstruction of the Lumbar Plexus With Respect to Lumbar Surgery." BMC Musculoskeletal Disorders, vol. 12, 2011, p. 76.
Lu S, Chang S, Zhang YZ, et al. Clinical anatomy and 3D virtual reconstruction of the lumbar plexus with respect to lumbar surgery. BMC Musculoskelet Disord. 2011;12:76.
Lu, S., Chang, S., Zhang, Y. Z., Ding, Z. H., Xu, X. M., & Xu, Y. Q. (2011). Clinical anatomy and 3D virtual reconstruction of the lumbar plexus with respect to lumbar surgery. BMC Musculoskeletal Disorders, 12, 76. https://doi.org/10.1186/1471-2474-12-76
Lu S, et al. Clinical Anatomy and 3D Virtual Reconstruction of the Lumbar Plexus With Respect to Lumbar Surgery. BMC Musculoskelet Disord. 2011 Apr 14;12:76. PubMed PMID: 21492461.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical anatomy and 3D virtual reconstruction of the lumbar plexus with respect to lumbar surgery. AU - Lu,Sheng, AU - Chang,Shan, AU - Zhang,Yuan-zhi, AU - Ding,Zi-hai, AU - Xu,Xin Ming, AU - Xu,Yong-qing, Y1 - 2011/04/14/ PY - 2010/12/01/received PY - 2011/04/14/accepted PY - 2011/4/16/entrez PY - 2011/4/16/pubmed PY - 2011/9/15/medline SP - 76 EP - 76 JF - BMC musculoskeletal disorders JO - BMC Musculoskelet Disord VL - 12 N2 - BACKGROUND: Exposure of the anterior or lateral lumbar via the retroperitoneal approach easily causes injuries to the lumbar plexus. Lumbar plexus injuries which occur during anterior or transpsoas lumbar spine exposure and placement of instruments have been reported. This study aims is to provide more anatomical data and surgical landmarks in operations concerning the lumbar plexus in order to prevent lumbar plexus injuries and to increase the possibility of safety in anterior approach lumbar surgery. METHODS: To study the applied anatomy related to the lumbar plexus of fifteen formaldehyde-preserved cadavers, Five sets of Virtual Human (VH) data set were prepared and used in the study. Three-dimensional (3D) computerized reconstructions of the lumbar plexus and their adjacent structures were conducted from the VH female data set. RESULTS: The order of lumbar nerves is regular. From the anterior view, lumbar plexus nerves are arranged from medial at L5 to lateral at L2. From the lateral view, lumbar nerves are arranged from ventral at L2 to dorsal at L5. The angle of each nerve root exiting outward to the corresponding intervertebral foramen increases from L1 to L5. The lumbar plexus nerves are observed to be in close contact with transverse processes (TP). All parts of the lumbar plexus were located by sectional anatomy in the dorsal third of the psoas muscle. Thus, access to the psoas major muscle at the ventral 2/3 region can safely prevent nerve injuries. 3D reconstruction of the lumbar plexus based on VCH data can clearly show the relationships between the lumbar plexus and the blood vessels, vertebral body, kidney, and psoas muscle. CONCLUSION: The psoas muscle can be considered as a surgical landmark since incision at the ventral 2/3 of the region can prevent lumbar plexus injuries for procedures requiring exposure of the lateral anterior of the lumbar. The transverse process can be considered as a landmark and reference in surgical operations by its relative position to the lumbar plexus. 3D reconstructions of the lumbar plexus based on VCH data provide a virtual morphological basis for anterior lumbar surgery. SN - 1471-2474 UR - https://www.unboundmedicine.com/medline/citation/21492461/Clinical_anatomy_and_3D_virtual_reconstruction_of_the_lumbar_plexus_with_respect_to_lumbar_surgery_ L2 - https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-12-76 DB - PRIME DP - Unbound Medicine ER -