Step by step teaching anatomy for anterior approach of the lumbar spine: A cadaveric study

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2025-02-21 DOI:10.1016/j.neuchi.2025.101650

Romain Quéhan , Hodabalo Essosolim Bakondé , Ariane Weyl , Antonio Francisco , Marina Poinsignon , Lubin Klotz , Patrick Chaynes , Amaury De Barros

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引用次数: 0

Abstract

Purpose

The authors described detailed relevant anatomy for anterior approach of the lumbosacral spine emphasizing all critical structures at risk for surgical injuries.

Methods

Two fresh adult male cadavers were dissected at the Toulouse anatomy department. For each specimen, a step-by-step surgical approach followed by broader anatomical dissection was performed.

Results

Results were divided into three compartments: anterior abdominal wall, latero/retroperitoneal space, lumbosacral prevertebral space. Each compartment was analyzed and visually described according to surgical and wider anatomical approach. Each region has critical anatomical structures that need to be well managed during surgery avoiding surgical complications. In the lumbosacral prevertebral space, the vascular anatomy is the most critical point to know to avoid potentially fatal surgical complications for patients. Ureter embedded into the posterior part of the peritoneum is also a critical structure to manage correctly during lumbosacral anterior approach. Different neural structures are also encountered with potential painful complications in case of injury.

Conclusions

In reference to anterior lumbosacral approach, critical structures to manage are peritoneum, ureter, prevertebral venous structures and hypogastric plexus. Their surgical anatomy has to be known and well recognized during surgery. Our surgical then broader anatomical dissections provide pragmatic pictural pedagogic content for teaching surgeons practicing anterior lumbosacral approach.

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.