Neutral hip position for the oblique lumbar interbody fusion (OLIF) approach increases the retroperitoneal oblique corri
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(2020) 21:583
RESEARCH ARTICLE
Open Access
Neutral hip position for the oblique lumbar interbody fusion (OLIF) approach increases the retroperitoneal oblique corridor Vit Kotheeranurak1, Weerasak Singhatanadgige2, Chindarat Ratanakornphan3, Wicharn Yingsakmongkol2, Richard A. Hynes4 and Worawat Limthongkul2*
Abstract Background: The prepsoas lateral approach for spinal fusion, oblique lateral lumbar interbody fusion (OLIF), is considered one of the minimally invasive spinal fusion methods and is gaining popularity due to improved outcomes with copious supporting evidence. To date, no publication has studied the various positions of the left hip in actual patients which might affect the retroperitoneal oblique corridor (ROC). The study aimed to find the relevancy of the left hip position and the size of ROC. Methods: We recruited 40 consecutive patients who needed diagnostic MRI from the out-patient clinic. MRI scan from L2 to L5 was performed in the supine, right lateral decubitus with hip flexion, and right lateral decubitus with hip in a neutral position. The retroperitoneal oblique corridor (ROC) was measured at the intervertebral disc level and compared. Results: ROC of the hip in neutral position was significantly larger than hip flexion in all levels (p < 0.05); there was no significant difference in the ROC among levels (p = 0.22). ROC seems to be largest at L2/3 followed by L3/4 and L4/5 respectively in all positions. Conclusions: The retroperitoneal oblique corridors of L2 to L5 were significantly increased when the hip is in the neutral position, while the psoas cross-sectional area and anterior thickness were minimized in this position. Surgeons might benefit from a neutral position of the left hip in the oblique lateral lumbar interbody fusion (OLIF) procedure. In conclusion, the retroperitoneal oblique corridors of L2 to L5 were significantly increased when the hip is in the neutral position, while the psoas cross-sectional area and anterior thickness were minimized in this position. Surgeons might benefit from a neutral position of the left hip in the oblique lateral lumbar interbody fusion procedure. Keywords: Retroperitoneal oblique corridor, ROC, Oblique lateral lumbar interbody fusion, OLIF, Hip position, MRI
* Correspondence: [email protected] 2 Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Rd, Pathumwan, Bangkok 10330, Thailand Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If
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