Comparison of conventional versus minimally invasive extraperitoneal approach for anterior lumbar interbody fusion

Saraph, V.; Lerch, Christian; Walochnik, Nadja; Bach, Christian; Krismer, Martin; Wimmer, Cornelius

doi:10.1007/s00586-004-0722-4

Cited by 101 publications

(56 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…20 Saraph et al compared a traditional open anterior approach with Mayer's MIS approach and found that although fusion and complication rates were similar in their study, the MIS group had shorter operating time, less blood loss, and decreased postoperative pain. 25 Silvestre et al used an MIS approach similar to that of Saraph et al and in addition described a "sliding window" technique that allowed for access to up to 3 disc levels through the same approach. The results with this technique were also similar to those of Saraph et al, with less blood loss, short operating times, and decreased risk of abdominal wall weakness and herniations.…”

Section: 1019mentioning

confidence: 99%

Retroperitoneal oblique corridor to the L2–S1 intervertebral discs in the lateral position: an anatomic study

Davis

Hynes²,

Fung

et al. 2014

SPI

165

145

View full text Add to dashboard Cite

Object Access to the intervertebral discs from L2–S1 in one surgical position can be challenging. The transpsoas minimally invasive surgical (MIS) approach is preferred by many surgeons, but this approach poses potential risk to neural structures of the lumbar plexus as they course through the psoas. The lumbar plexus and iliac crest often restrict the L4–5 disc access, and the L5–S1 level has not been a viable option from a direct lateral approach. The purpose of the present study was to investigate an MIS oblique corridor to the L2–S1 intervertebral disc space in cadaveric specimens while keeping the specimens in a lateral decubitus position with minimal disruption of the psoas and lumbar plexus. Methods Twenty fresh-frozen full-torso cadaveric specimens were dissected, and an oblique anatomical corridor to access the L2–S1 discs was examined. Measurements were taken in a static state and with mild retraction of the psoas. The access corridor was defined at L2–5 as the left lateral border of the aorta (or iliac artery) and the anterior medial border of the psoas. The L5–S1 corridor of access was defined transversely from the midsagittal line of the inferior endplate of L-5 to the medial border of the left common iliac vessel and vertically to the first vascular structure that crosses midline. Results The mean access corridor diameters in the static state and with mild psoas retraction, respectively, were as follows: at L2–3, 18.60 mm and 25.50 mm; at L3–4, 19.25 mm and 27.05 mm; and at L4–5, 15.00 mm and 24.45 mm. The L5–S1 corridor mean values were 14.75 mm transversely, from midline to the left common iliac vessel and 23.85 mm from the inferior endplate of L-5 cephalad to the first midline vessel. Conclusions The oblique corridor allows access to the L2–S1 discs while keeping the patient in a lateral decubitus position without a break in the table. Minimal psoas retraction without significant tendon disruption allowed for a generous corridor to the disc space. The L5–S1 disc space can be accessed from an oblique angle consistently with gentle retraction of the iliac vessels. This study supports the potential of an MIS oblique retroperitoneal approach to the L2–S1 discs.

show abstract

Section: 1019mentioning

confidence: 99%

Retroperitoneal oblique corridor to the L2–S1 intervertebral discs in the lateral position: an anatomic study

Davis

Hynes²,

Fung

et al. 2014

SPI

165

145

View full text Add to dashboard Cite

show abstract

“…Use of the NHP in musculo-skeletal research includes for example studies on osteoporosis [18,23,68], vertebroplasty [19,42], sciatica [40], low back fusions [60] and other musculo-skeletal disorders [15].…”

Section: Sickness Impact Profilementioning

confidence: 99%

Health related quality of life outcome instruments

Németh

2005

Eur Spine J

View full text Add to dashboard Cite

“…The reported incidence of sympathetic dysfunction after ALIF is from 1% to 43% and after XLIF 4% (ref. 7,[10][11][12][13][14] ).…”

Section: Introductionmentioning

confidence: 99%

Risk of sympathectomy after anterior and lateral lumbar interbody fusion procedures

Hrabálek¹,

Šternberský²,

Adamus³

2015

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

View full text Add to dashboard Cite

Aim. The aim of this study was to identify retrospectively, lumbar sympathectomy (SE) using thermography (TG) and to evaluate clinically, the severity of post-sympathectomy (post-SE) dysfunction after anterior and lateral lumbar interbody fusion procedures (ALIF, XLIF). Methods. Twenty eight patients with suspected SE were referred for TG to both legs. They completed our questionnaire on severity of difficulties after SE. We evaluated the ability of physical examinations to reveal the SE in contrast to TG and compared the symptoms (warmer leg and inhibited leg sweating) of SE with questionnaire responses as subjective measure and TG as objective measure. Results. SE was diagnosed in 0.5% after ALIF at L5/S1, in 15% after ALIF at Th12-L5 and in 4% after XLIF at T12-L5. SE severely reduced the quality of life in two cases. The ability to distinguish differences in leg temperature by palpation after SE was found in 32%. All physical examinations together were insufficient for reliably disclosing SE. Subjective symptoms of SE were often false positive and proven SE by TG was often a clinically false negative. Conclusion. This is the first study to examine post-SE dysfunction objectivelya using TG after ALIF and XLIF, and the first to evaluate clinically, the severity of the post-SE syndrome. Before surgery we cannot foresee potentially poor SE results. For this reason, injury to the sympathetic chain during surgery must be avoided. The advantage of TG for identifying SE is its non-invasiveness and reliability.

show abstract

Comparison of conventional versus minimally invasive extraperitoneal approach for anterior lumbar interbody fusion

Cited by 101 publications

References 39 publications

Retroperitoneal oblique corridor to the L2–S1 intervertebral discs in the lateral position: an anatomic study

Retroperitoneal oblique corridor to the L2–S1 intervertebral discs in the lateral position: an anatomic study

Health related quality of life outcome instruments

Risk of sympathectomy after anterior and lateral lumbar interbody fusion procedures

Contact Info

Product

Resources

About