Abstract
PurposeAlthough lumbar discectomy is the most common procedure in spine surgery, reports about anatomical relations between discs and prevertebral vessels are limited. Aim of this research was to investigate morphometric of the lumbar region and the relations between intervertebral discs (IVDs) and abdominal aorta.Methods557 abdominal computed tomography scans were assessed. For each spinal column level from Th12/L1 down to L4/L5, we investigated: intervertebral disc’s and vertebra’s height, width, length, and distance from aorta or common iliac artery (CIA). Those arteries were also measured in two dimensions and classified based on location.Results54.58% of patients were male. There was a significant difference in arterial-disc distances (ADDs) between genders at the levels: L1/L2 (1.32 ± 1.97 vs. 0.96 ± 1.78 mm; p = 0.0194), L2/L3 (1.97 ± 2.16 vs. 1.15 ± 2.01 mm; p < 0.0001), L3/L4 (2.54 ± 2.78 vs. 1.71 ± 2.61 mm; p = 0.0012), also for both CIAs (left CIA 3.64 ± 3.63 vs. 2.6 ± 3.06 mm; p = 0.0004 and right CIA: 7.96 ± 5.06 vs. 5.8 ± 4.57 mm; p < 0.001)—those ADDs were higher in men at all levels. The length and width of IVD increased alongside with disc level with the maximum at L4/L5.ConclusionBifurcations of the aorta in most cases occurred at the L4 level. Collected data suggest that at the highest lumbar levels, there is a greater possibility to cause injury of the aorta due to its close anatomical relationship with discs. Females have limited, in comparison to males, ADD at L1/L2, L2/L3, and L3/L4 levels what should be taken into consideration during preoperative planning of surgical intervention.
Highlights
In spine procedures, posterior lumbar disc surgery is the most performed
Lumbar discectomy is a common procedure in spine surgery, and at the same time, it can result in serious complications; reports about anatomical relations between discs or vertebrae and prevertebral vessels, especially the aorta and common iliac arteries, are limited [4, 11, 17]
Vascular complications can occur with an incidence of 1–5 in 10,000 disc operations, they most commonly appear at the L4/L5 level, result in arteriovenous fistulas and predominantly concern injury of common iliac artery, aorta or lumbar arteries [5, 22]
Summary
Posterior lumbar disc surgery is the most performed. It is considered a safe and effective treatment of herniated discs; the possibility of Department of Orthopedics, Traumatology, Microsurgery and Hand Surgery, Specialist Hospital, Jasło, PolandDepartment of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, PolandDepartment of Neurosurgery, Pomeranian Medical University, Szczecin, PolandFaculty of Medicine, Jagiellonian University Medical College, Św. Posterior lumbar disc surgery is the most performed. It is considered a safe and effective treatment of herniated discs; the possibility of Department of Orthopedics, Traumatology, Microsurgery and Hand Surgery, Specialist Hospital, Jasło, Poland. Faculty of Medicine, Jagiellonian University Medical College, Św. Lumbar discectomy is a common procedure in spine surgery, and at the same time, it can result in serious complications; reports about anatomical relations between discs or vertebrae and prevertebral vessels, especially the aorta and common iliac arteries, are limited [4, 11, 17]
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