What is the Wiltse approach?
The classical approach described by Wiltse is essentially minimally invasive, sparing both the muscle planes and soft tissues, allowing for ample far lateral lumbar decompression, including discectomy and fusion, with a low complication rate.
What is retroperitoneal surgical approach?
Classically, the retroperitoneal approach is performed through an incision through the abdominal wall. The incision may be paramedian, midline, or Pfannenstiel. The latest technique gains exposure via a less invasive lateral approach through the retroperitoneal fat and psoas major muscle.
What is Kambin’s triangle?
The Kambin’s triangle is defined as a right triangle over the dorsolateral disc. The hypotenuse is the exiting nerve root, the base (width) is the superior border of the caudal vertebra, and the height is the dura/traversing nerve root.
What is the multifidus muscle?
The multifidus muscle spans the whole length of the vertebral column but is most developed in the lumbar area. The multifidus muscle is from the local core stabilizers playing an important role in the static and dynamic spinal stability, weakness in the multifidus muscle is associated with low back pain.
What is Transperitoneal approach?
Anatomically, the transperitoneal approach is the most direct access to the interspace between the common iliac vessels. Similar to the retroperitoneal approach, the transperitoneal approach begins with a Pfannenstiel incision 5 cm above the pubis and vertical dissection through the linea alba.
What is a Xlif procedure?
Extreme lateral interbody fusion (XLIF) is a minimally invasive procedure performed through the side of the body to treat spinal disorders and reduce long-term back or leg pain that has not responded to other treatments, such as steroid injections, physical therapy and pain medication.
What is the average cost of an Epidural Steroid Injection?
On MDsave, the cost of an Epidural Steroid Injection ranges from $836 to $1,549. Those on high deductible health plans or without insurance can save when they buy their procedure upfront through MDsave.
What is a transforaminal injection?
What is transforaminal injection? Transforaminal injection can help relieve pain in your lower back, legs and feet caused by sciatica, herniated discs or other back problems. You have nerves that run from your spinal cord out to your legs.
How do you strengthen the multifidus?
The multifidus walk out is a great way to strengthen the multifidus in a more functional standing position. Since many daily activities that require spinal stabilization are done in standing, it’s important to train the multifidus in that same upright position. Attach a band to a secure object about chest height level.
Is a nephrectomy?
Nephrectomy (nephro = kidney, ectomy = removal) is the surgical removal of a kidney. The procedure is done to treat kidney cancer as well as other kidney diseases and injuries. Nephrectomy is also done to remove a healthy kidney from a donor (either living or deceased) for transplantation.
What is Transperitoneal nephrectomy?
Conclusion: A transperitoneal right subcostal incision for radical nephrectomy in patients with large and locally advanced tumors of the right kidney seems to offer better access to the renal pedicle, and to the great vessels of the area as well as better exposure of the organs of the abdominal cavity.
What is the Wiltse approach to the lumbar spine?
The approach described and popularized by Wiltse et al 5,7,10 is more medial in the cleft between the multifidus and longissimus parts of the sacrospinalis muscle. These three approaches allow the surgeon to reach the area to be fused or decompressed without incising many of the supporting structures.
What are the uses of the Wiltse paraspinal approach?
Its use for removing far lateral disc herniations, 6 decompressing a far-out syndrome, 8 inserting pedicle screws, and for spinal canal decompression have been described. 10 Despite the descriptions by Wiltse et al, the exact location of the sacrospinalis muscle and where it must be split are unclear.
What kind of incision is used for Wiltse?
Discussion The Wiltse approach is performed by median skin incision with lateral muscle dissection between the multifidus and the longissimus muscles, in a natural pathway.
Which is the best description of the Wiltse approach?
Background: The paraspinal, posterolateral, or Wiltse approach is an old technique that observes the principles of an MIS procedure. The aim of this study was to provide a step-by-step description from the literature of the Wiltse paraspinal approach and analyze its main advantages and limitations.