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Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position
Study Design Cadaveric study. Objective To compare the position of the femoral nerve within the lumbar plexus at the L4-L5 disc space in the lateral decubitus vs prone position. Methods Seven lumbar plexus specimens were dissected and the femoral nerve within the psoas muscle was identified and mark...
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| Published in: | Global spine journal 2023-09, Vol.13 (7), p.1765-1770 |
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| container_title | Global spine journal |
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| creator | Alluri, Ram Clark, Nicholas Sheha, Evan Shafi, Karim Geiselmann, Matthew Kim, Han Jo Qureshi, Sheeraz Dowdell, James |
| description | Study Design
Cadaveric study.
Objective
To compare the position of the femoral nerve within the lumbar plexus at the L4-L5 disc space in the lateral decubitus vs prone position.
Methods
Seven lumbar plexus specimens were dissected and the femoral nerve within the psoas muscle was identified and marked with radiopaque paint. Lateral fluoroscopic images of the cadaveric specimens in the lateral decubitus vs prone position were obtained. The location of the radiopaque femoral nerve at the L4-L5 disc space was normalized as a percentage of the L5 vertebral body (0% indicates posterior location and 100% indicates anterior location at the L4-L5 disc space). The location of the femoral nerve at L4-L5 in the lateral decubitus vs prone position was compared using a paired t test.
Results
In the lateral decubitus position, the femoral nerve was located 28% anteriorly from the posterior edge of the L4-L5 disc space, and in the prone position, the femoral nerve was relatively more posterior, located 18% from the posterior edge of the L4-L5 disc space (P = .037).
Conclusions
The femoral nerve was on average more posteriorly located at the L4-L5 disc space in the prone position compared to lateral decubitus. This more posterior location allows for a larger safe zone at the L4-L5 disc space, which may decrease the incidence of neurologic complications associated with Lateral lumbar interbody fusion in the prone vs lateral decubitus position; however, further studies are needed to evaluate this possible clinical correlation. |
| doi_str_mv | 10.1177/21925682211049170 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10556917</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_21925682211049170</sage_id><sourcerecordid>2580015206</sourcerecordid><originalsourceid>FETCH-LOGICAL-c444t-9d52a62b6c3d37eedee88df620af9a94cdce46e2db1f2287ce849ce53da41d013</originalsourceid><addsrcrecordid>eNp1kUFLAzEQhYMoVrQ_wNuCFy-tmdlsNnsSUavCoh7Ua0izs7rSbmqyW_Dfm1qpqJjLhJf3PmYyjB0CHwPk-QlCgZlUiABcFJDzLba30kaZLPj25q5wwIYhvPJ4JOYp4C4bpEJCrgD3WFk6a7rGtYmrk-6FkgnNnTez5Jb8kpKm_RRL09FKvCDbT5uuD8kT-RDLvXctJfcuNCvGAdupzSzQ8Kvus8fJ5cP59ai8u7o5PytHVgjRjYoqQyNxKm1apTlRRaRUVUvkpi5MIWxlSUjCago1osotKVFYytLKCKg4pPvsdM1d9NM5RXfbxe70wjdz49-1M43--dI2L_rZLTXwLP4O5JFw_EXw7q2n0Ol5EyzNZqYl1weNmeIcMuQyWo9-WV9d79s4n0YlI1CgzKIL1i7rXQie6k03wPVqX_rPvmJmvM4E80zf1P8DH9Axk3U</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2860554265</pqid></control><display><type>article</type><title>Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position</title><source>SAGE Open Access</source><source>Publicly Available Content Database</source><source>PubMed Central</source><creator>Alluri, Ram ; Clark, Nicholas ; Sheha, Evan ; Shafi, Karim ; Geiselmann, Matthew ; Kim, Han Jo ; Qureshi, Sheeraz ; Dowdell, James</creator><creatorcontrib>Alluri, Ram ; Clark, Nicholas ; Sheha, Evan ; Shafi, Karim ; Geiselmann, Matthew ; Kim, Han Jo ; Qureshi, Sheeraz ; Dowdell, James</creatorcontrib><description>Study Design
Cadaveric study.
Objective
To compare the position of the femoral nerve within the lumbar plexus at the L4-L5 disc space in the lateral decubitus vs prone position.
Methods
Seven lumbar plexus specimens were dissected and the femoral nerve within the psoas muscle was identified and marked with radiopaque paint. Lateral fluoroscopic images of the cadaveric specimens in the lateral decubitus vs prone position were obtained. The location of the radiopaque femoral nerve at the L4-L5 disc space was normalized as a percentage of the L5 vertebral body (0% indicates posterior location and 100% indicates anterior location at the L4-L5 disc space). The location of the femoral nerve at L4-L5 in the lateral decubitus vs prone position was compared using a paired t test.
Results
In the lateral decubitus position, the femoral nerve was located 28% anteriorly from the posterior edge of the L4-L5 disc space, and in the prone position, the femoral nerve was relatively more posterior, located 18% from the posterior edge of the L4-L5 disc space (P = .037).
Conclusions
The femoral nerve was on average more posteriorly located at the L4-L5 disc space in the prone position compared to lateral decubitus. This more posterior location allows for a larger safe zone at the L4-L5 disc space, which may decrease the incidence of neurologic complications associated with Lateral lumbar interbody fusion in the prone vs lateral decubitus position; however, further studies are needed to evaluate this possible clinical correlation.</description><identifier>ISSN: 2192-5682</identifier><identifier>EISSN: 2192-5690</identifier><identifier>DOI: 10.1177/21925682211049170</identifier><identifier>PMID: 34617812</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Cadavers ; Original ; Patient positioning ; Spine</subject><ispartof>Global spine journal, 2023-09, Vol.13 (7), p.1765-1770</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021. This work is licensed under the Creative Commons Attribution – Non-Commercial – No Derivatives License https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2021 2021 AO Spine, unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c444t-9d52a62b6c3d37eedee88df620af9a94cdce46e2db1f2287ce849ce53da41d013</citedby><cites>FETCH-LOGICAL-c444t-9d52a62b6c3d37eedee88df620af9a94cdce46e2db1f2287ce849ce53da41d013</cites><orcidid>0000-0002-6695-5593 ; 0000-0001-5919-707X ; 0000-0003-2111-7032 ; 0000-0002-7177-1756</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10556917/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2860554265?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,315,733,786,790,891,21994,25783,27886,27957,27958,37047,37048,44625,44980,45368,53827,53829</link.rule.ids></links><search><creatorcontrib>Alluri, Ram</creatorcontrib><creatorcontrib>Clark, Nicholas</creatorcontrib><creatorcontrib>Sheha, Evan</creatorcontrib><creatorcontrib>Shafi, Karim</creatorcontrib><creatorcontrib>Geiselmann, Matthew</creatorcontrib><creatorcontrib>Kim, Han Jo</creatorcontrib><creatorcontrib>Qureshi, Sheeraz</creatorcontrib><creatorcontrib>Dowdell, James</creatorcontrib><title>Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position</title><title>Global spine journal</title><description>Study Design
Cadaveric study.
Objective
To compare the position of the femoral nerve within the lumbar plexus at the L4-L5 disc space in the lateral decubitus vs prone position.
Methods
Seven lumbar plexus specimens were dissected and the femoral nerve within the psoas muscle was identified and marked with radiopaque paint. Lateral fluoroscopic images of the cadaveric specimens in the lateral decubitus vs prone position were obtained. The location of the radiopaque femoral nerve at the L4-L5 disc space was normalized as a percentage of the L5 vertebral body (0% indicates posterior location and 100% indicates anterior location at the L4-L5 disc space). The location of the femoral nerve at L4-L5 in the lateral decubitus vs prone position was compared using a paired t test.
Results
In the lateral decubitus position, the femoral nerve was located 28% anteriorly from the posterior edge of the L4-L5 disc space, and in the prone position, the femoral nerve was relatively more posterior, located 18% from the posterior edge of the L4-L5 disc space (P = .037).
Conclusions
The femoral nerve was on average more posteriorly located at the L4-L5 disc space in the prone position compared to lateral decubitus. This more posterior location allows for a larger safe zone at the L4-L5 disc space, which may decrease the incidence of neurologic complications associated with Lateral lumbar interbody fusion in the prone vs lateral decubitus position; however, further studies are needed to evaluate this possible clinical correlation.</description><subject>Cadavers</subject><subject>Original</subject><subject>Patient positioning</subject><subject>Spine</subject><issn>2192-5682</issn><issn>2192-5690</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>PIMPY</sourceid><recordid>eNp1kUFLAzEQhYMoVrQ_wNuCFy-tmdlsNnsSUavCoh7Ua0izs7rSbmqyW_Dfm1qpqJjLhJf3PmYyjB0CHwPk-QlCgZlUiABcFJDzLba30kaZLPj25q5wwIYhvPJ4JOYp4C4bpEJCrgD3WFk6a7rGtYmrk-6FkgnNnTez5Jb8kpKm_RRL09FKvCDbT5uuD8kT-RDLvXctJfcuNCvGAdupzSzQ8Kvus8fJ5cP59ai8u7o5PytHVgjRjYoqQyNxKm1apTlRRaRUVUvkpi5MIWxlSUjCago1osotKVFYytLKCKg4pPvsdM1d9NM5RXfbxe70wjdz49-1M43--dI2L_rZLTXwLP4O5JFw_EXw7q2n0Ol5EyzNZqYl1weNmeIcMuQyWo9-WV9d79s4n0YlI1CgzKIL1i7rXQie6k03wPVqX_rPvmJmvM4E80zf1P8DH9Axk3U</recordid><startdate>20230901</startdate><enddate>20230901</enddate><creator>Alluri, Ram</creator><creator>Clark, Nicholas</creator><creator>Sheha, Evan</creator><creator>Shafi, Karim</creator><creator>Geiselmann, Matthew</creator><creator>Kim, Han Jo</creator><creator>Qureshi, Sheeraz</creator><creator>Dowdell, James</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AFRWT</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6695-5593</orcidid><orcidid>https://orcid.org/0000-0001-5919-707X</orcidid><orcidid>https://orcid.org/0000-0003-2111-7032</orcidid><orcidid>https://orcid.org/0000-0002-7177-1756</orcidid></search><sort><creationdate>20230901</creationdate><title>Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position</title><author>Alluri, Ram ; Clark, Nicholas ; Sheha, Evan ; Shafi, Karim ; Geiselmann, Matthew ; Kim, Han Jo ; Qureshi, Sheeraz ; Dowdell, James</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c444t-9d52a62b6c3d37eedee88df620af9a94cdce46e2db1f2287ce849ce53da41d013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cadavers</topic><topic>Original</topic><topic>Patient positioning</topic><topic>Spine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alluri, Ram</creatorcontrib><creatorcontrib>Clark, Nicholas</creatorcontrib><creatorcontrib>Sheha, Evan</creatorcontrib><creatorcontrib>Shafi, Karim</creatorcontrib><creatorcontrib>Geiselmann, Matthew</creatorcontrib><creatorcontrib>Kim, Han Jo</creatorcontrib><creatorcontrib>Qureshi, Sheeraz</creatorcontrib><creatorcontrib>Dowdell, James</creatorcontrib><collection>SAGE Open Access</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Databases</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Global spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alluri, Ram</au><au>Clark, Nicholas</au><au>Sheha, Evan</au><au>Shafi, Karim</au><au>Geiselmann, Matthew</au><au>Kim, Han Jo</au><au>Qureshi, Sheeraz</au><au>Dowdell, James</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position</atitle><jtitle>Global spine journal</jtitle><date>2023-09-01</date><risdate>2023</risdate><volume>13</volume><issue>7</issue><spage>1765</spage><epage>1770</epage><pages>1765-1770</pages><issn>2192-5682</issn><eissn>2192-5690</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Study Design
Cadaveric study.
Objective
To compare the position of the femoral nerve within the lumbar plexus at the L4-L5 disc space in the lateral decubitus vs prone position.
Methods
Seven lumbar plexus specimens were dissected and the femoral nerve within the psoas muscle was identified and marked with radiopaque paint. Lateral fluoroscopic images of the cadaveric specimens in the lateral decubitus vs prone position were obtained. The location of the radiopaque femoral nerve at the L4-L5 disc space was normalized as a percentage of the L5 vertebral body (0% indicates posterior location and 100% indicates anterior location at the L4-L5 disc space). The location of the femoral nerve at L4-L5 in the lateral decubitus vs prone position was compared using a paired t test.
Results
In the lateral decubitus position, the femoral nerve was located 28% anteriorly from the posterior edge of the L4-L5 disc space, and in the prone position, the femoral nerve was relatively more posterior, located 18% from the posterior edge of the L4-L5 disc space (P = .037).
Conclusions
The femoral nerve was on average more posteriorly located at the L4-L5 disc space in the prone position compared to lateral decubitus. This more posterior location allows for a larger safe zone at the L4-L5 disc space, which may decrease the incidence of neurologic complications associated with Lateral lumbar interbody fusion in the prone vs lateral decubitus position; however, further studies are needed to evaluate this possible clinical correlation.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>34617812</pmid><doi>10.1177/21925682211049170</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-6695-5593</orcidid><orcidid>https://orcid.org/0000-0001-5919-707X</orcidid><orcidid>https://orcid.org/0000-0003-2111-7032</orcidid><orcidid>https://orcid.org/0000-0002-7177-1756</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2192-5682 |
| ispartof | Global spine journal, 2023-09, Vol.13 (7), p.1765-1770 |
| issn | 2192-5682 2192-5690 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10556917 |
| source | SAGE Open Access; Publicly Available Content Database; PubMed Central |
| subjects | Cadavers Original Patient positioning Spine |
| title | Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position |
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