Introduction: We describe a novel anterolateral approach utilizing the subpsoas space to perform minimal access lumbar discectomies and corpectomies. The subspoas space is a potential space between the underbelly of the psoas and the lateral vertebral wall.
Methods: Retrospective review of demographics and outcomes of all 10 cases of anterolateral exposures, subpsoas dissection for lumbar discetomies and corpectomies done by the senior author.
Results: Of the 10 cases, 4 corpectomies and 6 discetomies were reviewed, M:F 1:1, age range : 39 - 66. Duration of surgery ranged from 150 to 330 min and blood loss from 50 to 250 cc. Corpectomy cases were for metastatic pathological fractures, traumatic fractures and osteomyelitis. There were no new neurological deficits related to the approach. Nine patients had posterior fusion in addition to anterior fusion.
Conclusions: Dissecting the psoas off the spinal column to reach the subpsoas plain provides a safe anterolateral corridor for major lumbar vertebral reconstruction including corpectomy and interbody fusion with no plexus related deficits in this series.
Patient Care: Minimize neurological and general morbidity in major reconstructions of the lumbar spine
Learning Objectives: Understand the anatomy of this novel approach
Assess the outcome after surgery in this series of patients using a novel approach to the lumbar spine.