Level of variations of the aortic bifurcation and distance measurements between the aortic bifurcation and the common iliac bifurcations

Introduction: The purpose of the present study was to investigate the vertebral levels of the aortic bifurcation (AB) in patients with and without the abdominal aorta (AA) deviation and to measure the distances between the AB and the right-left common iliac bifurcations (CIBs) which are crucial anatomical information, especially for anterior lumbar interbody fusion surgery. Additionally, we made comparisons levels of the AB according to sex and examined whether the results were statistically significant, which we could not find other studies comparing gender in literature. Material and Methods: The images of 721 patients, undergoing angiography with multidetector computed tomography between January 2016 and October 2019, were reviewed retrospectively. The AB levels of the patients with and without the AA deviation were classified and evaluated separately. It was measured the distances between the level of the AB and the right and left CIBs with the 3-dimensional ruler technique in only 207 of 721 patients. Results: It was detected seven different vertebral levels of the AB among patients (116 patients) with the AA deviation, in which is the highest L4-upper (27.59%), and 11 different vertebral levels of the AB among patients (605 patients) without the AA deviation, in which is the highest L4-upper (22.48%). When comparing cases with and without AA deviation, a statistically significant difference was found between the sexes (P < 0.05). Discussion and Conclusion: The presented study demonstrates that there is a significant relationship between the genders at some levels. The preoperative information of the morphological variations of the AB may be very useful for laparoscopic, invasive procedures, and spinal surgery procedures. At the same time, these variation information reveals new information for anatomy.