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- W4376645222 abstract "Risks associated with the lateral approach for lumbar interbody fusion have been well-characterized. While much attention has been devoted to the identification and the avoidance of the lumbar plexus, there remains a significant risk to the anterior vascular and visceral structures, especially when patients present with aberrant anatomical features. Retrospective chart review was performed to describe a case report of the preoperative presentation of a patient with aberrant vascular anatomy. The patient is a 48-year-old female who presented with multi-level lumbar disc degeneration with a large right para-central disc protrusion. She was considered for lateral lumber interbody fusion. During routine preoperative axial magnetic resonance imaging (MRI) review, she was noted to have large, bilateral sub-psoas vessels. A hypoplastic inferior vena cava was identified which gave rise to large, ascending lumbar veins originating from the iliac veins—one each on the lateral aspect of the mid-lateral vertebral body through the lumbar to thoracic spine. A lateral transpsoas approach at this level was felt to be associated with increased risk for a vascular injury, and a one-level TLIF at L3-L4 was performed without complication. This rare case highlights a vascular anomaly and illustrates the need for a preoperative axial MRI evaluation of all cases to be performed in a transpsoas manner to identify soft tissue structures which may challenge the surgical approach." @default.
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- W4376645222 date "2023-06-01" @default.
- W4376645222 modified "2023-09-25" @default.
- W4376645222 title "Hypoplastic inferior vena cava as a substantial risk in the lateral transpsoas approach" @default.
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- W4376645222 doi "https://doi.org/10.1016/j.avsurg.2023.100196" @default.
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