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Jang HD, Lee JC, Choi SW, Hong CH, Suh YS, Shin BJ. A novel surgical approach using the "lateral corridor" for minimally invasive oblique lumbar interbody fusion at L5-S1: a clinical series and technical note. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:2611-2620. [PMID: 38819738 DOI: 10.1007/s00586-024-08217-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 02/23/2024] [Accepted: 03/06/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE The minimally invasive oblique lumbar interbody fusion (MI-OLIF) L5-S1 was introduced to overcome the limitations of conventional fusion techniques, however, MI-OLIF is not possible using the standard method due to vascular structures in some cases. We aimed to introduce the "lateral corridor" and report the details of the surgical technique with a clinical case series. METHODS We utilized the lateral access route of the left common iliac vein and named it the "lateral corridor", to distinguish the technique from the standard technique (central corridor). The type and frequency of branch vessels that required additional manipulations were reviewed, and the frequency of intraoperative vascular injury was investigated. RESULTS Among the 107 patients who underwent MI-OLIF L5-S1, 26 patients (24.3%) who received the "lateral corridor" technique were included. Branch vessel ligation was required in 42.3% of the patients. The types of branch vessels that required ligation were seven cases (26.9%) of the iliolumbar vein (ILV) and six cases (23.1%) of ascending lumbar vein (ALV). The ILV and ALV were ligated in two cases. None of the patients developed intraoperative vascular injuries. CONCLUSION We introduced the "lateral corridor" as an alternative approach for MI-OLIF L5-S1, implemented it in 24.3% of the patient cohort, and reported favorable outcomes devoid of vascular complications. The "lateral corridor" necessitated ligation of the ILV or ALV in 42.3% of cases. The "lateral corridor" approach appears to be a promising surgical technique, offering feasibility even in instances where the vascular anatomy precludes the employment of the conventional approach.
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Affiliation(s)
- Hae-Dong Jang
- Department of Orthopaedic Surgery, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Bucheon-si, Gyeonggi-do, 14584, Republic of Korea
| | - Jae Chul Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, Republic of Korea
| | - Sung-Woo Choi
- Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, Republic of Korea
| | - Chang-Hwa Hong
- Department of Orthopaedic Surgery, Soonchunhyang University Cheonan Hospital, 31 Soonchunhyang 6-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do, 31151, Republic of Korea
| | - You-Sung Suh
- Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, Republic of Korea
| | - Byung-Joon Shin
- Department of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, Republic of Korea.
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Zurcher KS, Staack SO, Spencer EB, Liska A, Alzubaidi SJ, Patel IJ, Naidu SG, Oklu R, Dymek RA, Knuttinen MG. Venous Anatomy and Collateral Pathways of the Pelvis: An Angiographic Review. Radiographics 2022; 42:1532-1545. [PMID: 35867595 DOI: 10.1148/rg.220012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The pelvic venous system is complex, with the potential for numerous pathways of collateralization. Owing to stenosis or occlusion, both thrombotic and nonthrombotic entities in the pelvis may necessitate alternate routes of venous return. Although the pelvic venous anatomy and collateral pathways may demonstrate structural variability, a number of predictable paths often can be demonstrated on the basis of the given disease and the level of obstruction. Several general categories of collateral pathways have been described. These pathway categories include the deep pathway, which is composed of the lumbar and sacral veins and vertebral venous plexuses; the superficial pathway, which is composed of the circumflex and epigastric vessels; various iliofemoral collateral pathways; the intermediate pathway, which is composed of the gonadal veins and the ovarian and uterine plexuses; and portosystemic pathways. The pelvic venous anatomy has been described in detail in cadaveric and anatomic studies, with the aforementioned collateral pathways depicted on CT and MR images in several imaging studies. A comprehensive review of the native pelvic venous anatomy and collateralized pelvic venous anatomy based on angiographic features has yet to be provided. Knowledge of the diseases involving a number of specific pelvic veins is of clinical importance to interventional and diagnostic radiologists and surgeons. The ability to accurately identify common collateral patterns by using multiple imaging modalities, with accurate anatomic descriptions, may assist in delineating underlying obstructive hemodynamics and diagnosing specific occlusive disease entities. ©RSNA, 2022.
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Affiliation(s)
- Kenneth S Zurcher
- From the Division of Vascular and Interventional Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ (K.S.Z., S.O.S., S.J.A., I.J.P., S.G.N., R.O., M.G.K.); Minimally Invasive Procedure Specialists, Highlands Ranch, Colo (E.B.S., A.L.); and University of Illinois College of Medicine at Chicago, Chicago, IL (R.A.D.)
| | - Sasha O Staack
- From the Division of Vascular and Interventional Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ (K.S.Z., S.O.S., S.J.A., I.J.P., S.G.N., R.O., M.G.K.); Minimally Invasive Procedure Specialists, Highlands Ranch, Colo (E.B.S., A.L.); and University of Illinois College of Medicine at Chicago, Chicago, IL (R.A.D.)
| | - E Brooke Spencer
- From the Division of Vascular and Interventional Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ (K.S.Z., S.O.S., S.J.A., I.J.P., S.G.N., R.O., M.G.K.); Minimally Invasive Procedure Specialists, Highlands Ranch, Colo (E.B.S., A.L.); and University of Illinois College of Medicine at Chicago, Chicago, IL (R.A.D.)
| | - Addison Liska
- From the Division of Vascular and Interventional Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ (K.S.Z., S.O.S., S.J.A., I.J.P., S.G.N., R.O., M.G.K.); Minimally Invasive Procedure Specialists, Highlands Ranch, Colo (E.B.S., A.L.); and University of Illinois College of Medicine at Chicago, Chicago, IL (R.A.D.)
| | - Sadeer J Alzubaidi
- From the Division of Vascular and Interventional Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ (K.S.Z., S.O.S., S.J.A., I.J.P., S.G.N., R.O., M.G.K.); Minimally Invasive Procedure Specialists, Highlands Ranch, Colo (E.B.S., A.L.); and University of Illinois College of Medicine at Chicago, Chicago, IL (R.A.D.)
| | - Indravadan J Patel
- From the Division of Vascular and Interventional Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ (K.S.Z., S.O.S., S.J.A., I.J.P., S.G.N., R.O., M.G.K.); Minimally Invasive Procedure Specialists, Highlands Ranch, Colo (E.B.S., A.L.); and University of Illinois College of Medicine at Chicago, Chicago, IL (R.A.D.)
| | - Sailendra G Naidu
- From the Division of Vascular and Interventional Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ (K.S.Z., S.O.S., S.J.A., I.J.P., S.G.N., R.O., M.G.K.); Minimally Invasive Procedure Specialists, Highlands Ranch, Colo (E.B.S., A.L.); and University of Illinois College of Medicine at Chicago, Chicago, IL (R.A.D.)
| | - Rahmi Oklu
- From the Division of Vascular and Interventional Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ (K.S.Z., S.O.S., S.J.A., I.J.P., S.G.N., R.O., M.G.K.); Minimally Invasive Procedure Specialists, Highlands Ranch, Colo (E.B.S., A.L.); and University of Illinois College of Medicine at Chicago, Chicago, IL (R.A.D.)
| | - Ryanne A Dymek
- From the Division of Vascular and Interventional Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ (K.S.Z., S.O.S., S.J.A., I.J.P., S.G.N., R.O., M.G.K.); Minimally Invasive Procedure Specialists, Highlands Ranch, Colo (E.B.S., A.L.); and University of Illinois College of Medicine at Chicago, Chicago, IL (R.A.D.)
| | - Martha-Gracia Knuttinen
- From the Division of Vascular and Interventional Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ (K.S.Z., S.O.S., S.J.A., I.J.P., S.G.N., R.O., M.G.K.); Minimally Invasive Procedure Specialists, Highlands Ranch, Colo (E.B.S., A.L.); and University of Illinois College of Medicine at Chicago, Chicago, IL (R.A.D.)
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DePietro DM, Carlon T, Trerotola SO, Sudheendra D. Endovascular Treatment of an Anatomically Complex Iliac Lesion and a Review of Variant Iliac Venous Anatomy. J Vasc Interv Radiol 2019; 31:260-264. [PMID: 31883936 DOI: 10.1016/j.jvir.2019.08.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/28/2019] [Accepted: 08/31/2019] [Indexed: 10/25/2022] Open
Abstract
The diagnosis and treatment of pelvic venous disease is complicated by a number of potential venous anatomic variants. Stent-assisted recanalization of a chronically occluded left external iliac vein draining directly into the inferior vena cava, with absence of the left common iliac vein, is described here. Variant iliac venous anatomy is reviewed in 3 categories: additional iliac vessels, absence/shortening of iliac vessels, and deviations in the drainage pattern of iliac vessels. Additionally, variations of the ascending lumbar and iliolumbar veins, the identification of which can aid in the treatment of pelvic venous disease, are described.
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Affiliation(s)
- Daniel M DePietro
- Department of Radiology, Division of Interventional Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., 1 Silverstein, Philadelphia, PA 19104.
| | - Tim Carlon
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Scott O Trerotola
- Department of Radiology, Division of Interventional Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., 1 Silverstein, Philadelphia, PA 19104
| | - Deepak Sudheendra
- Department of Radiology, Division of Interventional Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., 1 Silverstein, Philadelphia, PA 19104
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