PMID- 35000337
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220122
IS  - 2586-6583 (Print)
IS  - 2586-6591 (Electronic)
IS  - 2586-6591 (Linking)
VI  - 18
IP  - 4
DP  - 2021 Dec
TI  - An Anatomical Clue for Minimizing Iliac Vein Injury During the Anterolateral 
      Approach at L5-S1 Level: A Cadaveric Study.
PG  - 833-838
LID - 10.14245/ns.2142494.247 [doi]
AB  - OBJECTIVE: The injury to the common iliac vein (CIV) seems to be the most 
      important concern during the anterior approach to the spine at L5-S1 level. We 
      investigated the anatomy of the L5-S1 vertebral structures related to the CIV 
      through a cadaveric study to find an anatomical clue for safe dissection of CIV. 
      METHODS: Ten cadavers were prepared for this study. After removing the peritoneum 
      and the presacral fascia, the section from the lower part of the L5 to the upper 
      part of the S1 vertebral body was removed with the CIV attached. After 
      decalcification, 2 sections in the vertical and horizontal directions were made 
      for histological study. RESULTS: An adipose tissue layer was present between the 
      intervertebral disc and CIV. The adipose tissue layer in 6 cadavers was thin, and 
      in 3 of these cadavers, the CIV was attached to the vertebral body and the disc. 
      In the other 4 cadavers, the CIV was clearly separated from the vertebral body 
      and the disc by the intervening adipose tissue layer (IATL). Under the 
      microscope, a thin layer surrounding the anterior longitudinal ligament, 
      periosteum, and disc was observed, and we named this structure the 'perivertebral 
      membrane'. The perivertebral membrane was attached to the CIV when there was no 
      IATL, but a potential space was detected under the membrane. CONCLUSION: There 
      was a thin membrane, perivertebral membrane, between the CIV and L5-S1 disc. In 
      cases with CIV adhesion to the disc due to the absence of IATL, the CIV may be 
      mobilized indirectly through the perivertebral membrane.
FAU - Ko, Myeong Jin
AU  - Ko MJ
AD  - Department of Neurosurgery, Chung-Ang University Hospital, Seoul, Korea.
FAU - Park, Seung Won
AU  - Park SW
AD  - Department of Neurosurgery, Chung-Ang University Hospital, Seoul, Korea.
FAU - Wui, Seong Hyun
AU  - Wui SH
AD  - Department of Neurosurgery, Chung-Ang University Hospital, Seoul, Korea.
LA  - eng
GR  - Chung-Ang University/
PT  - Journal Article
DEP - 20211231
PL  - Korea (South)
TA  - Neurospine
JT  - Neurospine
JID - 101724936
PMC - PMC8752704
OTO - NOTNLM
OT  - Anatomy
OT  - Anterior approach
OT  - Iliac Vein
OT  - Lumbosacral region
OT  - Spine
COIS- The authors have nothing to disclose.
EDAT- 2022/01/10 06:00
MHDA- 2022/01/10 06:01
PMCR- 2021/12/01
CRDT- 2022/01/09 23:42
PHST- 2021/05/09 00:00 [received]
PHST- 2021/08/28 00:00 [accepted]
PHST- 2022/01/09 23:42 [entrez]
PHST- 2022/01/10 06:00 [pubmed]
PHST- 2022/01/10 06:01 [medline]
PHST- 2021/12/01 00:00 [pmc-release]
AID - ns.2142494.247 [pii]
AID - ns-2142494-247 [pii]
AID - 10.14245/ns.2142494.247 [doi]
PST - ppublish
SO  - Neurospine. 2021 Dec;18(4):833-838. doi: 10.14245/ns.2142494.247. Epub 2021 Dec 
      31.