دورية أكاديمية
أعرض في EDS

The Effect of Patient Position on Psoas Morphology and in Lumbar Lordosis.

التفاصيل البيبلوغرافية
العنوان: The Effect of Patient Position on Psoas Morphology and in Lumbar Lordosis.
المؤلفون: Amaral R; Instituto de Patologia da Coluna (IPC), São Paulo, SP, Brazil., Daher MT; Centro de Reabilitação e Readaptação Dr. Henrique Santillo (CRER), Goiânia, GO, Brazil., Pratali R; Hospital do Servidor Público Estadual, São Paulo, SP, Brazil., Arnoni D; Instituto de Patologia da Coluna (IPC), São Paulo, SP, Brazil., Pokorny G; Instituto de Patologia da Coluna (IPC), São Paulo, SP, Brazil. Electronic address: g.pokorny@patologiadacoluna.com.br., Rodrigues R; Instituto de Patologia da Coluna (IPC), São Paulo, SP, Brazil., Batista M; Instituto de Patologia da Coluna (IPC), São Paulo, SP, Brazil., Fortuna PP; Centro de Reabilitação e Readaptação Dr. Henrique Santillo (CRER), Goiânia, GO, Brazil., Pimenta L; Instituto de Patologia da Coluna (IPC), São Paulo, SP, Brazil; University of California, San Diego (UCSD), San Diego, California, USA., Herrero CFPS; Professor Doutor do Departamento de Ortopedia e Anestesiologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP - Ribeirão Preto (SP), Brazil.
مؤلفون مشاركون: Brazilian Spine Study Group
المصدر: World neurosurgery [World Neurosurg] 2021 Sep; Vol. 153, pp. e131-e140. Date of Electronic Publication: 2021 Jun 22.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 101528275 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-8769 (Electronic) Linking ISSN: 18788750 NLM ISO Abbreviation: World Neurosurg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York : Elsevier
مواضيع طبية MeSH: Lordosis/*diagnostic imaging , Lumbar Vertebrae/*surgery , Patient Positioning/*methods , Psoas Muscles/*diagnostic imaging , Spinal Fusion/*methods, Adult ; Aged ; Female ; Humans ; Lumbar Vertebrae/diagnostic imaging ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prone Position ; Supine Position ; Young Adult
مستخلص: Introduction: Among the interbody fusions, lateral lumbar interbody fusion allows access to the lumbar spine through the major psoas muscle, which offers several advantages to the spine surgeon. However, some of its drawbacks cause surgeons to avoid using it as a daily practice. Therefore, to address some of these challenges, we propose the prone transpsoas technique, differing mainly from the traditional technique on patient position-moving from lateral to prone decubitus, theoretically enhancing the lordosis and impacting the psoas morphology.
Methods: Twenty-four consecutive patients were invited to have magnetic resonance imaging examinations in 3 different positions (prone, dorsal, lateral). Two observers measured the following parameters: vertebral body size, psoas diameter, psoas anterior border distance, plexus distance, total lumbar lordosis, distal lumbar lordosis, and proximal lumbar lordosis. Values of P < 0.05 were deemed significant.
Results: The prone position yielded a significant increase in the lumbar lordosis, both in L1-S1 (57° vs. 46.5°) and proximal lordosis (40.4° vs. 36.9°) compared with the lateral position. Regarding the morphologic aspects, patients in the prone position presented lesser psoas muscles forward shift, but no difference was noted in the plexus position neither for L3-L4 nor L4-L5.
Conclusions: The prone position resulted in a significantly increased lumbar lordosis, both distal and proximal, which may enable the spine surgeon to achieve significant sagittal restoration just by positioning. The prone position also produced a posterior retraction of the psoas muscle. However, it did not significantly affect the position of the plexus concerning the vertebral body.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Anatomy; Lateral lumbar interbody fusion; Magnetic resonance; Prone position
تواريخ الأحداث: Date Created: 20210624 Date Completed: 20211108 Latest Revision: 20211108
رمز التحديث: 20221213
DOI: 10.1016/j.wneu.2021.06.067
PMID: 34166827
قاعدة البيانات: MEDLINE
الوصف
تدمد:1878-8769
DOI:10.1016/j.wneu.2021.06.067