International journal of spine surgery
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We investigated impact of vertebral axial rotation on neurovascular anatomy in adult spinal deformity (ASD) patients and provided recommendations on the approach based on degree of axial rotation. In order to isolate vertebral rotation (VR) impact from the superimposed degenerative cascade observed in adulthood, adolescent idiopathic scoliosis (AIS) patients were analyzed. ⋯ Preoperative review of MRI scans should occur to assess the patient's safe surgical corridor for lateral lumbar interbody fusion (LLIF). Adult spinal deformity surgeons who approach a degenerated spine in patients with progressive AIS in adulthood must carefully plan for patient positioning, neurovascular anatomy, and realignment objectives prior to the day of surgical intervention.