• Journal of Korean Neurosurgical Society
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• 제66권2호
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• pp.155-161
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• 2023

Objective : To analyze the anatomical location of the ureter in relation to lateral lumbar interbody fusion and evaluate the potential risk of ureteral injury. Methods : One hundred eight patients who performed contrast-enhanced computed tomographic scans were enrolled in this study. The location of the ureter from L2-L3 to L4-L5 was evaluated. The distances between the ureter and psoas muscle, intervertebral disc, and retroperitoneal vessels were also recorded bilaterally. Results : Over 30% of the ureters were close to the working corridor of extreme lumbar interbody fusion at L2-L3. Most of the ureters were close to working corridor of oblique lumbar interbody fusion, especially at L4-L5. The distance from the ureter to the great vessels on the left side was significantly narrowing from L2-L3 to L4-L5 (28.8±9.5 mm, 22.0±8.0 mm, 15.5±8.4 mm), and it was significantly larger than that on the right side (12.3±6.1 mm, 7.4±5.7 mm, 5.4±4.4 mm). Conclusion : Our findings indicate that the location of the ureter varies widely among individuals. To avoid unexpected damage to the ureter, it is imperative to directly visualize it and verify the ureter is not in the surgical pathway during lateral lumbar interbody fusion.

• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.684-690
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• 2017

Objective : As increasing the size of the geriatric population, the number of elderly patients, who need the surgery for painful degenerative spinal stenosis has been increasing. The geriatric population may be relatively high complications, because of age and age-associated medical conditions. However, there is a lack of studies addressing the perioperative complications and outcomes in elderly patients with posterior lumbar inter body fusion with screw augmentation (PLIF). Methods : We retrospectively reviewed the medical records and radiographic studies of geriatric patients who had spine surgery of PLIF due to spinal stenosis for 11 years. We divided into 2 groups (A; 70-75 years, B; over then 76 years) according to the age. Surgical level of each groups, hospital day and postoperative day, co-morbidities, complications, clinical outcomes were analyzed. Operative reports, hospital and outpatient clinic charts, and radiographic studies were reviewed. Results : Group A was composed of 80 patients, their mean age was 72.21 and female dominant (n=46), and their mean surgically fused level was 1.52 level. Group B was 36 patients, their mean age was 78.83 and female dominant (n=20), and their mean surgically fused level was 1.36 level. Comparing between two groups, complications, postoperative hospital stay were slightly increase in group B and co-morbidity was statistically high in group B, however clinical outcomes were similar between two groups. Conclusion : Increasing age might be an important risk factor for complications in patients undergoing PLIF, however, we would like to recommend that if the situation of spine of extreme geriatric patients need PLIF, it should be in the surgeon's consideration after careful selection and clinical judgement.