Abstract
BackgroundOblique lateral interbody fusion surgery has become increasingly popular for lumbar degenerative diseases. The oblique corridor is between the psoas muscle and the retroperitoneal vessels, and its use could result in decreased tissue trauma, minimal blood loss, and short operation times. Patients who undergo oblique lateral interbody fusion surgery are always placed in the right lateral position to avoid damage to the inferior vena cava, which is typically a right-sided vessel. There is a substantial risk of vascular injury during the operation if there are anatomical variations in the vessels.Case presentationA 77-year-old man, of the Han nationality, with lumbar spinal stenosis underwent stand-alone oblique lateral interbody fusion surgery. Transverse magnetic resonance imaging of the lumbar spine indicated that his inferior vena cava was left-sided. A three-dimensional reconstructed image of abdominal computed tomography angiography showed that the inferior vena cava was located on the left side. Finally, the surgeon decided to change the position of our patient from a right lateral position to a left lateral position before the surgery.ConclusionsTo date, this is the first reported case where a patient underwent oblique lateral interbody fusion surgery in a left lateral decubitus position due to a left-sided inferior vena cava. This case demonstrates that carefully reading radiological results is important for operation planning and avoiding anatomical complications.
Highlights
ConclusionsThis is the first reported case where a patient underwent oblique lateral interbody fusion surgery in a left lateral decubitus position due to a left-sided inferior vena cava
Oblique lateral interbody fusion surgery has become increasingly popular for lumbar degenerative diseases
Compared to previous fusion techniques, such as posterior lumbar interbody fusion (PLIF), anterior lumbar interbody fusion (ALIF), and extreme lateral interbody fusion (XLIF)/direct lateral interbody fusion (DLIF), Oblique lateral interbody fusion (OLIF) is a direct mini-open approach via the psoas major muscle and abdominal aorta; for this surgery, it was decided that almost all patients would be placed in the right lateral decubitus position because the inferior vena cava (IVC) is typically a
Summary
A left-sided IVC is uncommon but clinically significant Up to now, this is the first reported case of a patient who was diagnosed as having lumbar spinal stenosis and underwent stand-alone OLIF surgery in the left lateral decubitus position due to the presence of a leftsided IVC. Awareness of variations in the IVC is crucial for the choice of an operation window during OLIF surgery, which could avoid many anatomically relevant complications. This patient may offer a good example of anatomical variations; surgeons should be aware of anatomical variations in vessels before performing operations
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