Anatomical evaluation of lumbar nerves using diffusion tensor imaging and implications of lateral decubitus for lateral transpsoas approach.
Yasuhiro OikawaYawara EguchiAtsuya WatanabeSumihisa OritaKazuyo YamauchiMiyako SuzukiYoshihiro SakumaGo KubotaKazuhide InageTakeshi SainohJun SatoKazuki FujimotoMasao KodaTakeo FuruyaKoji MatsumotoYoshitada MasudaYasuchika AokiKazuhisa TakahashiSeiji OhtoriPublished in: 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 (2017)
The L3/4 and L4/5 nerve roots are located posterior to the vertebral body center. These were found to be offset to the rear when the hip is flexed or the lateral decubitus position is assumed. The present study is the first to elucidate changes in the course of the lumbar nerves as this varies by position. The lateral decubitus position or the position supine with hips flexed may be useful for avoiding nerve damage in a direct lateral transpsoas approach. Preoperative DTI seems to be useful in evaluating the lumbar nerve course as it relates anatomically to the vertebral body.