Lateral Gutter Spine Anatomy

In its normal state it is tissue paper thin but can become thickened scarred and contracted as a consequence of injury and causes ankylosis and painful tethering of the quadriceps tendon.

Lateral gutter spine anatomy.

Inferior to the inferior border of the 12 th rib. Superiorly 5 cm above the shoulder joint to allow proper visualization of the upper airways. The vertebral body consists of an outer ring of very strong very dense cortical bone surrounding the softer spongy cancellous aka trabecular bone in the center. Lateral gutter the lateral gutter should be visualized and again a similar inspection to the medial gutter should be performed looking for synovitis loose bodies and marginal osteophytes.

In a posterolateral gutter fusion the surgical approach to the spine is from the back through a midline incision that is approximately three inches to six inches long. Posterolateral gutter spine fusion surgery description. Most spine surgeons work through the same incision to obtain the bone graft and to perform the spinal fusion. The popliteal hiatus should be identified in this area fig.

Approaches to ventral lesions of the thoracic spine include dorsal dorsolateral lateral and ventrolateral approaches. A lumbar posterolateral gutter fusion is done in the lower back at l1 through l2 through l5 through s1 at the bottom of the spine. Lateral recess stenosis ie lateral gutter stenosis subarticular stenosis subpedicular stenosis foraminal canal stenosis intervertebral foramen stenosis is defined as narrowing less than 3 4. First bone graft is obtained from the pelvis the iliac crest although some form of bone graft substitute may also be used.

The posterolateral gutter fusion is considered by many surgeons as the tried and true method of spinal fusion. This area is located along the very outer edges of the spinal structure. These approaches usually involve the removal of facet and pedicles with a high speed drill. Any type of spine fusion joins together or fuses a spinal segment to eliminate the motion at that level of the spine.

54 7 and a gentle milking maneuver should be performed to assess for the presence of loose bodies that may move back and forth within the popliteal hiatus. The main paracolic gutter lies lateral to the colon on each side. The dorsal approaches include laminectomy the lateral gutter approach and the transpedicular approach. It is most commonly done at l4 through l5 or l5 through s1 as these are the segments most likely to degenerate.

The left medial paracolic gutter. In spinal fusion surgery the doctor implants either a device or bone material to help re stabilize the spine. Lateral view of the intervertebral disc on the anterior column of the spine are the large round vertebral bodies. Gutter and across the suprapatellar pouch flaring out in the lateral gutter to a remnant or to no structure at all.

In posterolateral gutter fusion surgery the doctor places an implant at the posterolateral portion of the spine. The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon.