Localization of the Lumbar Plexus in the Psoas Muscle: Considerations for Avoiding Lumbar Plexus Injury during the Transpsoas Approach

Transpsoas lumbar spine surgery is a minimally invasive procedure with good corrective effects, but it can lead to nerve complications. This study investigates the anatomical location of the lumbar plexus within the psoas muscle to help surgeons avoid nerve injury during this approach. The researchers examined 27 cadavers, cutting the psoas muscle at different lumbar levels (L2/3, L3/4, L4/5) and measuring the position of the lumbar plexus. They calculated the location of the plexus relative to the psoas muscle's dimensions. The study found that the lumbar plexus is located in the posterior and medial part of the psoas muscle, shifting towards a more posterior and lateral position at the L4/5 level. Understanding this location is crucial for surgeons to avoid nerve damage during transpsoas procedures.

• 1
  The lumbar plexus is located in the posterior one-third and medial one-third of the psoas muscle.
• 2
  At the L4/5 level, the lumbar plexus shifts to a more posterolateral location within the psoas muscle.
• 3
  There were significant differences in lumbar plexus localization between L2/3 and L4/5, and between L3/4 and L4/5, in both the anterior-posterior and lateral-medial directions.