Trans-psoas Approach
Trans-psoas Approach - Related Videos
05:30
Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
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2025
Interbody fusion of the lumbar spine can be achieved surgically using different techniques. Minimally invasive techniques, including lateral interbody fusion, have been developed within recent decades to reduce rates of complications and allow for quicker patient recovery. We provide insight into stand-alone lateral trans-psoas interbody fusion, highlighting potential complications and pitfalls.
06:02
Posterior Approach for Debridement of the Psoas Abscess
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2020
This is a cadaveric study investigating the landmarks for the posterior approach for irrigation and debridement of the psoas abscess. The interval between the transverse processes (TP) was used to access the substance of the psoas muscle.
05:10
Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
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Cited by 3 •
2023
This protocol presents the procedure for conducting thyroidectomy using the gasless endoscopic thyroidectomy trans-axillary approach (GETTA).
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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Cited by 18 •
2018
The aim of this paper is to describe the different steps of the endoscopic endonasal approach to the sella turcica.
03:21
Trans-Spinal Direct Current Stimulation of a Rat's Spinal Motoneuron
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2025
This video describes the in vivo intracellular recording of rat motoneurons under trans-spinal direct current stimulation. The protocol describes how to measure membrane properties and record the rhythmic firing of motoneurons before, during, and after anodal or cathodal polarization of the spinal cord.
FAQs
The lateral route reaches the lumbar disc by traversing the psoas rather than dissecting through the posterior spinal muscles and ligaments. This changes which tissues are exposed during access and can reduce disruption in the posterior region. The tradeoff is that the psoas and nearby neural structures become the principal tissues requiring protection during the procedure.
Imaging helps the surgeon identify the operative level and plan the lateral path toward the disc. Neural monitoring provides additional information while instruments pass through the psoas, helping identify a potentially unsafe relationship to neural structures. Together, these tools support selection and maintenance of a safe corridor, although they do not eliminate the possibility of nerve irritation or related symptoms.
Restoring intervertebral disc height can increase the vertical space around the neural foramina, the openings through which spinal nerves pass. This may indirectly enlarge a narrowed foramen without requiring direct posterior decompression. The effect is therefore structural and indirect, and the approach is used for this purpose only in selected patients whose anatomy and clinical problem are appropriate.
Passing through the psoas can injure or irritate the muscle or nearby neural structures. Reported concerns include sensory changes, nerve irritation, and weakness involving hip flexion. These risks reflect the anatomy of the lateral corridor and must be weighed against potential benefits such as reduced posterior tissue disruption, disc-height restoration, and improved alignment.
The patient is positioned laterally, and imaging is used to identify the target level and a suitable corridor. Neural monitoring accompanies the approach as the surgeon gently dilates through the psoas. After reaching the intervertebral disc, the surgeon can perform the planned disc-space procedure, including lumbar interbody fusion when indicated.
Surgeons may consider the trans-psoas route when lateral access to a lumbar disc can address the patient’s surgical objective while limiting posterior muscle and ligament disruption. Potential goals include lumbar interbody fusion, restoration of disc height, improvement of spinal alignment, or indirect enlargement of narrowed neural foramina. Its use remains selective because psoas and neural risks must be considered.
The approach can support lumbar interbody fusion while restoring disc height and improving spinal alignment. Increased disc height may also indirectly enlarge narrowed neural foramina, potentially addressing the structural component of foraminal narrowing. These are procedural and anatomical goals rather than guaranteed results, so the expected benefit depends on whether the patient’s condition is suitable for this route.