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Research ArticleLumbar Spine

The Surgical Vascular Anatomy of the Lower Lumbar Arteries and Its Implications in Minimally Invasive Spine Surgery: A Cadaveric Study

André R. Pinho, Pedro A. Pereira, Maria João Leite, Cristina C. Santos, Ricardo P. Vaz and M. Dulce Madeira
International Journal of Spine Surgery July 2022, 8298; DOI: https://doi.org/10.14444/8298
André R. Pinho
1 Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
2 Orthopedic and Traumatology Department, Centro Hospitalar Universitário de São João (CHUSJ), Porto, Portugal
3 Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
MD
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Pedro A. Pereira
1 Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
3 Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
PhD
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Maria João Leite
2 Orthopedic and Traumatology Department, Centro Hospitalar Universitário de São João (CHUSJ), Porto, Portugal
MD, PhD
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Cristina C. Santos
3 Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
4 Faculty of Medicine, Department of Community Medicine, Information and Health Decision Sciences-MEDCIDS, University of Porto, Porto, Portugal
PhD
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Ricardo P. Vaz
1 Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
3 Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
5 Otorhinolaryngology Department, Centro Hospitalar Universitário de São João (CHUSJ), Porto, Portugal
MD, PhD
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M. Dulce Madeira
1 Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
3 Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
MD, PhD
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    Figure

    Dissection of the posterior abdominal wall and exemplification of how some of the measurements were obtained. (A) Distance between the left fourth lumbar artery and the superior and inferior border of the fourth lumbar vertebra, at the medial border of the psoas major muscle. (B) Length of the left third lumbar artery from the origin to the medial border of the psoas major muscle. (C) Length of the median sacral artery from the origin to the inferior border of the fifth lumbar vertebra. Ao, abdominal aorta; Ps, psoas major muscle; IVC, inferior vena cava; U, left ureter; *, third left lumbar artery; **, fourth left lumbar artery; #, left lumbar sympathetic trunk; S, median sacral artery; IM, inferior mesenteric artery; LCIV, left common iliac vein; I, inferior; S, superior; Ri, right side; Le, left side.

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    Table 1

    Lumbar arteries measurements in millimeters (mm).

    ParameterMeasured,mmOverallWomenMen
    Left Median(Range)Right Median(Range)Left Median(Range)Right Median(Range)Left Median(Range)Right Median(Range)
    Length of the third lumbar artery from origin to the medial border of the psoas major muscle22.00(10–36)31.00(24–41)22.00(10–36)30.00(24–41)24.00(14–30)32.00(25–40)
    Length of the fourth lumbar artery from origin to the medial border of the psoas major muscle23.00(11–35)29.00(24–40)24.00(11–35)32.00(26–35)21.50(18–30)26.00(24–40)
    Distance between the third lumbar artery and the superior border of the third lumbar vertebrae10.50(6–14)11.00(3–19)10.00(6–14)11.00(5–15)12.00(6–13)12.00(3–19)
    Distance between the fourth lumbar artery and the superior border of the fourth lumbar vertebrae6.00(2–12)7.50(−2 to 11)4.00(2–12)6.00(−2 to 11)6,5(4–11)8.00(0–11)
    • View popup
    Table 2

    Median distance between the origin of the median sacral artery and the upper border of the body of the fifth lumbar vertebra.

    ParameterMedian (Range)
    WomanMan
    Distance between the origin of the median sacral artery and the upper border of the body of the fifth lumbar vertebra, mm53.00(32–86)60.00(28–69)
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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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The Surgical Vascular Anatomy of the Lower Lumbar Arteries and Its Implications in Minimally Invasive Spine Surgery: A Cadaveric Study
André R. Pinho, Pedro A. Pereira, Maria João Leite, Cristina C. Santos, Ricardo P. Vaz, M. Dulce Madeira
International Journal of Spine Surgery Jul 2022, 8298; DOI: 10.14444/8298

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The Surgical Vascular Anatomy of the Lower Lumbar Arteries and Its Implications in Minimally Invasive Spine Surgery: A Cadaveric Study
André R. Pinho, Pedro A. Pereira, Maria João Leite, Cristina C. Santos, Ricardo P. Vaz, M. Dulce Madeira
International Journal of Spine Surgery Jul 2022, 8298; DOI: 10.14444/8298
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