Lumbar Plexus Anatomy within the Psoas Muscle: Implications for the Transpsoas Lateral Approach to the L4-L5 Disc by Timothy T. Davis, Hyun W. Bae, MAJ.

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Lumbar Plexus Anatomy within the Psoas Muscle: Implications for the Transpsoas Lateral Approach to the L4-L5 Disc by Timothy T. Davis, Hyun W. Bae, MAJ James M. Mok, Alexandre Rasouli, and Rick B. Delamarter J Bone Joint Surg Am Volume 93(16): August 17, 2011 ©2011 by The Journal of Bone and Joint Surgery, Inc.

Left lateral view of a left-sided specimen, made after dissection of the psoas muscle (ps). Timothy T. Davis et al. J Bone Joint Surg Am 2011;93: ©2011 by The Journal of Bone and Joint Surgery, Inc.

Right lateral view of right-sided specimen, showing the needle placed in the midcoronal plane and contacting the ventral aspect of the femoral nerve. Timothy T. Davis et al. J Bone Joint Surg Am 2011;93: ©2011 by The Journal of Bone and Joint Surgery, Inc.

Schematic diagrams depicting the anteroposterior location of the nervous tissue making up the femoral nerve at the L4-L5 disc space; in one specimen (not shown), the femoral nerve was identified in Zone 2. Timothy T. Davis et al. J Bone Joint Surg Am 2011;93: ©2011 by The Journal of Bone and Joint Surgery, Inc.

Lateral fluoroscopic view and neurogram of the femoral nerve following injection of contrast agent during a transforaminal steroid injection of the L4 nerve root. Timothy T. Davis et al. J Bone Joint Surg Am 2011;93: ©2011 by The Journal of Bone and Joint Surgery, Inc.

Dorsal view photograph, with the cadaver in the left lateral decubitus position, made after a right-sided transpsoas lateral approach with a currently commercially available retractor. Timothy T. Davis et al. J Bone Joint Surg Am 2011;93: ©2011 by The Journal of Bone and Joint Surgery, Inc.