{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:00:38Z","timestamp":1780470038944,"version":"3.54.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate how the position of iliac vessels affects the choice of surgical approach (left or right oblique abdominal incision) and window (central or lateral) during L5-S1 oblique lumbar interbody fusion (OLIF), through imaging anatomy research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>CT and axial T2-weighted MRI at L5-S1 were used to evaluate the iliac vessels\u2019 position and classify the central vascular window (CW). Measurements were taken for the central window (CW), distance from the midline of the L5-S1 disc to the vessel's medial surface (DV), and psoas to iliac vein distances (LPV\/RPV). Classification was based on the location of the common iliac vein\/internal iliac artery: The intervertebral space was divided evenly from anterior to posterior into four zones\u2014I, II, III, and IV. Based on iliac vein positions, patients were classified as follows: Type A (both veins in Zone I, left I\/right I), Type B (left I\/right II), Type C (left II\/right I), Type D (both veins in Zone II, left II\/right II), and Other Type (veins in Zone III or IV). A comparative analysis of imaging findings was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>302 patients were included (124 Type A, 30 Type B, 62 Type C, 82 Type D), and the remaining 4 patients, whose iliac veins were located in Zone III or IV, were defined as Other Type. Gender differences were observed, with Type A predominantly female. Type A had the smallest CW, while Type D had the largest. Type D showed the largest DV and RDV compared to other types. LPV and RPV were statistically significant between groups, with Type A and B having greater LPV than C and D.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Classification based on iliac vessel positioning helps determine the optimal approach for OLIF: Left ATP-OLIF is preferred for Type A and B; Right ATP-OLIF or Left O-ALIF for Type C; Left O-ALIF for Type D. The classification simplifies approach selection, minimizing vascular and nerve damage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1764671","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:01:32Z","timestamp":1780466492000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Classification of iliac vessels and selection of surgical approach and window in oblique lumbar interbody fusion at L5-S1 based on magnetic resonance imaging"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhao","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, The Third Hospital of Shijiazhuang","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Hebei General Hospital","place":["Shijiazhuang, 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