Your browser doesn't support javascript.
loading
Variations of the extrapsoas course of the lumbar plexus with implications for the lateral transpsoas approach to the lumbar spine: a cadaveric study.
Benes, Michal; Zido, Michal; Machac, Petr; Kaiser, Radek; Khadanovich, Anhelina; Nemcova, Simona; Kunc, Vojtech; Kachlik, David.
Afiliação
  • Benes M; Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
  • Zido M; Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic.
  • Machac P; Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic.
  • Kaiser R; Department of Neurology, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
  • Khadanovich A; Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic.
  • Nemcova S; Department of Traumatology, University of Szeged, Szeged, Hungary.
  • Kunc V; Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
  • Kachlik D; Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Acta Neurochir (Wien) ; 166(1): 319, 2024 Aug 02.
Article em En | MEDLINE | ID: mdl-39093448
ABSTRACT

BACKGROUND:

Together with an increased interest in minimally invasive lateral transpsoas approach to the lumbar spine goes a demand for detailed anatomical descriptions of the lumbar plexus. Although definitions of safe zones and essential descriptions of topographical anatomy have been presented in several studies, the existing literature expects standard appearance of the neural structures. Therefore, the aim of this study was to investigate the variability of the extrapsoas portion of the lumbar plexus in regard to the lateral transpsoas approach.

METHODS:

A total of 260 lumbar regions from embalmed cadavers were utilized in this study. The specimens were dissected as per protocol and all nerves from the lumbar plexus were morphologically evaluated.

RESULTS:

The most common variation of the iliohypogastric and ilioinguinal nerves was fusion of these two nerves (9.6%). Nearly in the half of the cases (48.1%) the genitofemoral nerve left the psoas major muscle already divided into the femoral and genital branches. The lateral femoral cutaneous nerve was the least variable one as it resembled its normal morphology in 95.0% of cases. Regarding the variant origins of the femoral nerve, there was a low formation outside the psoas major muscle in 3.8% of cases. The obturator nerve was not variable at its emergence point but frequently branched (40.4%) before entering the obturator canal. In addition to the proper femoral and obturator nerves, accessory nerves were present in 12.3% and 9.2% of cases, respectively.

CONCLUSION:

Nerves of the lumbar plexus frequently show atypical anatomy outside the psoas major muscle. The presented study provides a compendious information source of the possibly encountered neural variations during retroperitoneal access to different segments of the lumbar spine.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cadáver / Músculos Psoas / Vértebras Lombares / Plexo Lombossacral Limite: Aged / Female / Humans / Male Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cadáver / Músculos Psoas / Vértebras Lombares / Plexo Lombossacral Limite: Aged / Female / Humans / Male Idioma: En Ano de publicação: 2024 Tipo de documento: Article