Arterial complications following anterior lumbar interbody fusion: report of eight cases

Kulkarni, Samir S.; Lowery, Gary L.; Ross, Raymond; Sankar, Kamarena; Lykomitros, Vasilios

doi:10.1007/s00586-002-0460-4

Cited by 109 publications

(27 citation statements)

References 12 publications

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“…On the contrary, the anterior approaches with intervertebral fusion present a greater risk for the large vessels and other intra and retroperitoneal structures. 57 The incidence of dural breakage during surgery that is cited in the literature, varies between 5.5% and 10.1% (5.8% -7/120, 5.5% -13/236, 10.1% -36/ 356). 3,58,59 In our series it occurred in only one patient (2.77%) with degenerative listhesis associated to important alterations of the facet joints and severe stenosis of the canal.…”

Section: Complicationsmentioning

confidence: 99%

Posterior lumbar interbody fusion with instrumented posterolateral fusion in adult spondylolisthesis: description and association of clinico-surgical variables with prognosis in a series of 36 cases

2015

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Although a higher level of training is necessary, we believe that the described technique is a very effective decision in cases of spondylolisthesis, isthmic or degenerative, refractory to conservative treatment, for the obtaining the best clinical results and rates of fusion, with similar risks to those of the other published techniques. Our statistical analysis could contribute to improve outcomes after surgery.

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Section: Complicationsmentioning

confidence: 99%

Posterior lumbar interbody fusion with instrumented posterolateral fusion in adult spondylolisthesis: description and association of clinico-surgical variables with prognosis in a series of 36 cases

2015

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“…Finally, a twofold increased VTE risk was found in the event of an anterior approach in LBS. The risk of blood vessel injury during such procedures has been described; however, only a few studies have shown an increased VTE risk [39,40]. Villavicencio et al observed a higher risk of pulmonary embolism after anterior lumbar fusion (versus posterior), whereas Qureshi et al found an increased DVT risk with an anterior versus a posterior approach [41,42].…”

Section: Discussionmentioning

confidence: 99%

Thromboembolic risk after lumbar spine surgery: a cohort study on 325 000 French patients

Bouyer

Rudnichi

Dray‐Spira

et al. 2018

Journal of Thrombosis and Haemostasis

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Background Postoperative venous thromboembolism (VTE) is a severe complication, the risk of which after lumbar spine surgery (LBS) is not precisely known. Objective To estimate the incidence of VTE after LBS, and to identify individual and surgical risk factors. Methods All patients aged >18 years who underwent LBS in France between 2009 and 2014 were identified. Among 477 024 patients screened, exclusions concerned recent VTE or surgery, and multiple surgeries during the same hospital stay. Results In 323 737 patients (mean age 52.9 years, 51.4% male), we observed 2911 events (0.91%) after a median time of 12 days (Q1-Q3: 5-72 days). The multivariate adjusted Cox model showed increased risks associated with age (4% per year of age; 95% confidence interval [CI] 3.8-4.3), obesity (hazard ratio [HR] 1.32, 95% CI 1.18-1.46), active cancer (HR 1.65, 95% CI 1.5-1.82), previous thromboembolism (HR 5.41, 95% CI 4.74-6.17), severe paralysis (HR 1.47, 95% CI 1.17-1.84), renal disease (HR 1.28, 95% CI 1.04-1.6), psychiatric disease (HR 1.21, 95% CI 1.1-1.32), use of antidepressants (HR 1.13, 95% CI 1.03-1.24), use of contraceptives (HR 1.56, 95% CI 1.19-2.03), extended surgery for scoliosis (HR 3.61, 95% CI 2.96-4.4), implantation of pedicular screws with a 'dose-effect' association, and an anterior approach (HR 1.97, 95% CI 1.6-2.43) or a combined approach (HR 2.03, 95% CI 1.44-2.84). Conclusions The overall VTE risk after LBS is moderate (< 1%) but is widely modulated by several easily identifiable risk factors. The surgical community should be aware of this heterogeneity, adapt prevention according to patients and to the procedure, and use drug prophylaxis in the event of a high risk being present.

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“…In a study of 336 cases of ALIF treatment, Kulkarni et al . 13 found 5 cases of common iliac artery thrombosis. Of these, four cases were related to the left side artery and one case was related to the right side; two cases were treated with the extraperitoneal approach and three cases were treated with an abdominal approach; one case was diagnosed during surgery and the other cases were diagnosed ≤16 h after surgery.…”

Section: Discussionmentioning

confidence: 99%

Large blood vessel stretch in lumbar spine through anterior surgical approach: An experimental study in adult goat

Liu

Wang

Zhou

et al. 2014

IJOO

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Background:Various anterior lumbar surgical approaches, including the minimally invasive approach, have greatly improved in recent years. Vascular complications resulting from ALIF are frequently reported. Little information is available about the safety of large blood vessel stretch. We evaluated the right side stretch limit (RSSL) of the abdominal aorta (AAA) and the inferior vena cava (IVC) without blood flow occlusion and investigated stretch-induced histological injury and thrombosis in the iliac and femoral arteries and veins and the stretched vessels.Materials and Methods:The RSSL of blood vessels in five adult goats was measured by counting the number of 0.5-cm-thick wood slabs that were inserted between the right lumbar edge and the stretch hook. Twenty seven adult goats were divided into three groups to investigate histological injury and thrombosis under a stretch to 0.5 cm (group I) 1.5 cm (group II) for 2 h, or no stretch (group III). Blood vessel samples from groups I and II were analyzed on postsurgical days 1, 3, and 7. Thrombogenesis was examined in the iliac and femoral arteries and veins.Results:The RSSL of large blood vessels in front of L4/5 was 1.5 cm from the right lumbar edge. All goats survived surgery without complications. No injury or thrombosis in the large blood vessels in front of the lumbar vertebrae and in the iliac or femoral arteries and veins was observed. Under light microscopy, group I showed slight swelling of endothelial cells in the AAA and no histological injury of the IVC. The AAA of group II showed endothelial cell damage, unclear organelles, and incomplete cell connections by electron microscopy.Conclusions:The AAA and IVC in a goat model can be stretched by ≤0.5 cm, with no thrombosis in the AAA, IVC, iliac or femoral arteries and veins.

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Arterial complications following anterior lumbar interbody fusion: report of eight cases

Cited by 109 publications

References 12 publications

Posterior lumbar interbody fusion with instrumented posterolateral fusion in adult spondylolisthesis: description and association of clinico-surgical variables with prognosis in a series of 36 cases

Posterior lumbar interbody fusion with instrumented posterolateral fusion in adult spondylolisthesis: description and association of clinico-surgical variables with prognosis in a series of 36 cases

Thromboembolic risk after lumbar spine surgery: a cohort study on 325 000 French patients

Large blood vessel stretch in lumbar spine through anterior surgical approach: An experimental study in adult goat

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