Posterolateral musculo-fascial approach to the lumbar spine intervertebral discs: Anatomical study

Abstract

Objective: assess an anatomical and topographic parameter of the wound channel formed when using the posterolateral muscular-fascial approach to determine the possibility of its clinical use for performing decompres-sive-stabilizing surgical interventions. Material and methods: on the material of 20 cadavers of both sexes with different body mass index (mean 25.1 ±2.9) aged 54 to 76 years (median 67.5 years), who died from diseases not associated with the pathology of the spine, was modeled the posterolateral muscular-fascial approach to the lumbar spine. During the research were studied wound length, wound depth, wound depth index, access zone and the angle of intersection of the wound edges and the surface of surgical instruments. Results: the average length of the surgical wound during the lateral muscular-fascial approach was 149.75±6.35 mm. The average wound depth was 116.75±8.85 mm. The average value of the index of the depth of the surgical wound with interfascial access is 77.96±5.04. The average area of the intervertebral disc available for removal was 71.2±2.8%. The length of the aperture in the fibrous ring averages 15.8±0.78 mm. The average value of the angle of intersection of the wound edge and the pedicle screw implantation trajectory was 3.15±1.25. Conclusion: the assessment of the anatomical and topographic parameters of the wound channel formed during the posterolateral muscular-fascial approach allows us to conclude that this surgical approach can be used to improve the functional outcomes of decompressive and stabilizing interventions in the lumbar spine.