Anatomical and Morphological Research for Laparoscopic Anterior Lumbar Interbody Fusion / 中国微创外科杂志

ABSTRACT

Objective To study the vascular anatomy for laparoscopic anterior lumbar interbody fusion(LALIF),and to evaluate the feasibility of the surgical approach.Methods Vascular anatomy of 36 adult human bodies were studied by infusing red latex into the arteries.They were classified according to the percentage of the exposed lumbosacral disc in the interiliac triangle.Results The mean height of the aortic bifurcation(AB)was(41.81?13.82)mm,and the height of the confluence of the common iliac vein(CCIV)was(20.22?14.20)mm.The angles of the AB and CCIV were(51.88?12.09)? and(77.08?20.98)? respectively.The width of the median sacral artery(MSA)were(1.57?0.42)mm and(1.33?0.50)mm respectively at the top and bottom of the lumbosacral disc.While the distance from the right iliac vessel(RIV)to MSA at the top and bottom of the lumbosacral disc were(20.83?7.73)mm and(27.60?7.80)mm.The average width of the exposed disc was(36.78?13.06)mm,which accounts for(72.29?25.64)% of that of the disc.According to our morphological classification,22 specimens(61.1%)belong to type Ⅰ(Standard type,being exposed by more than 65%),9(25.0%)type Ⅱ(Narrow type,being exposed by 45% to 65%),and 5(13.9%)type Ⅲ(Barrier type,being exposed by less than 45%).The height of CCIV was negatively,but not significantly,correlate to its angle(r=-0.287,P=0.089).Conclusions In 86.1% of our patients,anterior approach is a safe and effective way for laparoscopic interbody fusion.Moreover,in 61.1% of the patients,the procedure can be carried out without managing the iliac vessels arround the interiliac triangle.