Article Figures & Data
Figures
- Figure 1
Transpsoas approach characterization by division of the psoas major into four zones. The psoas major was divided anterior-to-posterior into four equally sized zones using IMPAX6 measurement software.
- Figure 2
Anterior-to-psoas (ATP) approach characterization. The ATP approach was measured as the distance between the anteromedial aspect of the psoas major and the posterolateral aspect of the vasculature (line segments AB and CD).
- Figure 3
Measuring technique for structures at risk within anterior-to-psoas (ATP) and transpsoas (TP) approaches. The presence of obstruction by a given anatomical structure was recorded if the structure was within ATP and TP borders. Degree of obstruction was calculated as the quotient of the structure measurement within the ATP or TP approach (solid arrows) divided by the entire corridor length at the point of obstruction (hatched lines). If a structure occupied an entire zone (eg, kidney in TP zone #1 as shown above), this was recorded as 100% obstruction.
Tables
Characteristic Male
n = 50Female
n = 50Age, y 53.4 (18.4) 53.9 (12.9) Body mass index 30.2 (7.1) 29.7 (6.9) Height, cm 174.0 (8.3) 162.5 (8.5) Weight, kg 91.5 (23.1) 78.3 (18.8) Disc Level Right Side Left Side Kidney Liver Rib Kidney Spleen Rib Percentage of Time the Kidneys, Spleen, Liver, and Ribs Are Present in ATP Approach L1 to L2 37% 56% 33% 44% 22% 41% L2 to L3 43% 30% 10% 26% 10% 11% L3 to L4 11% 9% 0% 5% 3% 0% L4 to L5 0% 0% 0% 0% 0% 0% L5 to S1 0% 0% 0% 0% 0% 0% Percentage of Obstruction Caused by Kidneys, Spleen, Liver, and Ribs When Present in ATP Approach L1 to L2 67.9% 92.5% 30.1% 42% 54% 37% L2 to L3 66.3% 92.2% 20.0% 44.9% 50.0% 26.6% L3 to L4 78.9% 100% NA 53.9% 57.1% NA L4 to L5 NA NA NA NA NA NA L5 to S1 NA NA NA NA NA NA Abbreviations: ATP, anterior-to-psoas; NA, not applicable.
Disc Level Right Side Left Side Zone #1 Zone #2 Zone #3 Zone #4 Zone #1 Zone #2 Zone #3 Zone #4 Percentage of Time Kidneys are Present in TP Approach L1 to L2 82% 80% 76% 74% 91% 91% 89% 83% L2 to L3 75% 75% 68% 64% 80% 80% 74% 62% L3 to L4 21% 21% 16% 12% 21% 20% 19% 14% L4 to L5 2% 2% 3% 4% 0% 1% 2% 2% L5 to S1 0% 0% 0% 0% 0% 0% 0% 0% Percentage of Obstruction Caused by Kidneys When Present in TP Approach L1 to L2 99.8% 98.3% 97.7% 95.5% 99.9% 98.7% 96.2% 96.4% L2 to L3 98.6% 93.8% 97.4% 93.2% 93.0% 96.1% 88.5% 96.2% L3 to L4 95.3% 85.7% 84.0% 95.7% 87.9% 88.5% 77.0% 87.9% L4 to L5 100% 100% 88.3% 88.2% NA 58.5% 67% 100% L5 to S1 NA NA NA NA NA NA NA NA Abbreviations: NA, not applicable; TP, transpsoas.
Disc Level Right Side Left Side Zone #1 Zone #2 Zone #3 Zone #4 Zone #1 Zone #2 Zone #3 Zone #4 Percentage of Time Ribs Are Present in TP Approach L1 to L2 67% 62% 64% 68% 76% 81% 78% 84% L2 to L3 59% 53% 56% 58% 27% 23% 21% 24% L3 to L4 0% 0% 0% 0% 0% 0% 0% 0% L4 to L5 0% 0% 0% 0% 0% 0% 0% 0% L5 to S1 0% 0% 0% 0% 0% 0% 0% 0% Percentage of Obstruction Caused by Ribs When Present in TP Approach L1 to L2 82.6% 68.3% 69.4% 83.4% 82.5% 81.9% 74.8% 93.9% L2 to L3 75.8% 63.3% 67.7% 76.5% 100% 54% 41% 93% L3 to L4 NA NA NA NA NA NA NA NA L4 to L5 NA NA NA NA NA NA NA NA L5 to S1 NA NA NA NA NA NA NA NA Abbreviation: NA, not applicable.
Disc Level Right Side Left Side Zone #1 Zone #2 Zone #3 Zone #4 Zone #1 Zone #2 Zone #3 Zone #4 Percentage of Time Iliac Crest Is Present in TP Approach L1 to L2 0% 0% 0% 0% 0% 0% 0% 0% L2 to L3 0% 0% 0% 0% 0% 0% 0% 0% L3 to L4 0% 0% 0% 0% 0% 0% 0% 0% L4 to L5 32% 40% 50% 50% 29% 45% 54% 55% L5 to S1 88% 89% 89% 89% 87% 88% 89% 89% Percentage of Obstruction Caused by Iliac Crest When Present in TP Approach L1 to L2 NA NA NA NA NA NA NA NA L2 to L3 NA NA NA NA NA NA NA NA L3 to L4 NA NA NA NA NA NA NA NA L4 to L5 82.0% 87.1% 90.0% 99.8% 81.9% 76.1% 93.2% 97.1% L5 to S1 98.9% 99.0% 100% 100% 98.1% 99.2% 99.1% 100% Abbreviation: NA, not applicable.
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