Video-Assisted Versus Open Anterior Lumbar Spine Fusion Surgery

Escobar, Enrique; Transfeldt, Ensor E.; Garvey, Timothy A.; Ogilvie, James W.; Graber, John N.; Schultz, Leonard S.

doi:10.1097/01.brs.0000051912.04345.96

Cited by 45 publications

(13 citation statements)

References 24 publications

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“…76 Retrograde ejaculation has been reported in 0.44% to 25% of open and endoscopic cases. 46,78,83,85,[99][100][101][102][103] The ureter can be injured during anterior and posterior lumbar spine exposures. [104][105][106] It usually is adherent to the posterior peritoneum and is swept forward in retroperitoneal exposures.…”

Section: Complications Of Anterior Lumbar Spine Exposurementioning

confidence: 99%

“…108,109 There have been numerous descriptions of ureteral injury secondary to anterior lumbar spine exposure. 46,64,96,103,109,110 Although the exact incidence of the complication is uncertain, in larger reported series 46,64,103 of anterior exposures, it ranged from 0.3% to 8.0%. Like arterial thromboses, retraction as well as division may cause ureteral disruption.…”

Section: Complications Of Anterior Lumbar Spine Exposurementioning

confidence: 99%

“…103,109,110 Although some cases of partial transection can be treated by drainage of fluid collections and/or placement of ureteral stents, others may result in prolonged, complicated courses, perhaps including nephrectomy. 96,103,105,[110][111][112][113] Routine prophylactic use of ureteral stents in spine operations has not been recommended. [114][115][116][117] Various nerves are liable to injury in retroperitoneal operations.…”

Section: Complications Of Anterior Lumbar Spine Exposurementioning

confidence: 99%

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Methods and Complications of Anterior Exposure of the Thoracic and Lumbar Spine

Ikard¹

2006

Arch Surg

135

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To review the methods and complications of exposing the anterior aspects of the thoracic and lumbosacral spine. Data Sources: PubMed (journals database of the National Library of Medicine), text books, the University HealthSystem Consortium Clinical Process Improvement Benchmarking Project, a newspaper, and the US government Healthcare Cost and Utilization Project. Study Selection: Descriptions of morbidity and mortality specifically related to anterior spine exposure depicted in both case reports and clinical series were used. Data Extraction: Mortality data from clinical series with more than 30 cases were tabulated. Morbidity incidences were described. Data Synthesis: The frequency of anterior exposure of the spine for structural operations is steadily increasing. Both thoracic and lumbosacral anterior spine operations are associated with exposure-related complication rates of 10% to 50%. Pulmonary complications are frequent after thoracic exposures. Chylothorax is the most common of several rarer chest-exposure complications. Vascular complications, particularly arterial thrombosis (Ͻ1% of cases) and venous bleeding (2%-15% of cases), are the most frequent complications at the lumbar level. Other lumbosacral exposure complications include ureteral and nerve (somatic and sympathetic) injury. The mortality rate in anterior spine exposures is less than 1%. Conclusions: The exposure portions of anterior spine operations result in numerous complications. There are fewer reported complications with endoscopic exposures of the anterior spine than with open exposures, although endoscopic exposures have been used for less complicated cases. In comparable cases, neither exposure nor results of endoscopic operations have proven better than operations done through minilaparotomy incisions. Perioperative cooperation between exposing and spine surgeons is necessary to enhance results in anterior spine operations.

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Section: Complications Of Anterior Lumbar Spine Exposurementioning

confidence: 99%

Section: Complications Of Anterior Lumbar Spine Exposurementioning

confidence: 99%

Section: Complications Of Anterior Lumbar Spine Exposurementioning

confidence: 99%

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Methods and Complications of Anterior Exposure of the Thoracic and Lumbar Spine

Ikard¹

2006

Arch Surg

135

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“…Injuries to the spine in the region of the Th/L junction and particularly below L2 can be treated with the technique of retroperitoneal endoscopic approach 27 . On the other hand, purely endoscopic methods are frequently burdened by a higher percentage of intraoperative and postoperative complications compared to open techniques, as highlighted in the study by Escobar 28 . As an alternative to treatment of the anterior column of the spine with endoscopic techniques using four ports, in 2001 Kossmann described a minimally invasive technique using SynFrame retractor to open minithoracotomy about 4-6 cm long 5 .…”

Section: Discussionmentioning

confidence: 88%

Minimally invasive thoracoscopic approach to thoracolumbar junction fractures

Kočiš¹,

Kelbl²,

Wendsche³

et al. 2016

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims.A retrospective analysis of patients with thoracolumbar junction fractures who underwent video-assisted thoracoscopic surgery via a minimally invasive approach (minithoracotomy) for reconstruction of the anterior spinal column. Methods. Between 2002 and 2014, a total of 176 patients were treated by this technique. The patients received either posterior stabilization and, at the second stage, the minimally invasive technique via an anterior approach, or the minimally invasive anterior procedure alone. Results. In the anterior procedure, the average operative time was 90 min. (50 to 130 min). Bony fusion without complications was achieved in all patients within a year of surgery. The loss of correction after the anterior procedure with an allograft or titanium cage was up to 2 degrees at two years follow-up. Conclusion. The minimally invasive approach (minithoracotomy up to 6-7 cm) combined with thoracoscopy is an alternative to an exclusively endoscopic technique enabling us to provide safe surgical treatment of the anterior spinal column.

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“…The complications associated with the anterior approach to the lower lumbar spine are summarized in Table 1. The incidence of vascular injury is estimated at 1.9-8 %, with the greatest risk at the L4-L5 level [3][4][5]. Ureteral injury during anterior lumbar arthrodesis has been reported in only a small number of cases [3,[5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Analysis of intraoperative difficulties and management of operative complications in revision anterior exposure of the lumbar spine: a report of 25 consecutive cases

et al. 2012

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Purpose After a first anterior approach to the lumbar spine, formation of adhesions of soft tissues to the spine increases the surgical difficulties and potential for iatrogenic injury during the revision exposure. The objective of this study was to identify the intraoperative difficulties and postoperative complications associated with revision anterior lumbar spine procedures in a single institution. Methods This is a retrospective review of 25 consecutive anterior revision lumbar surgeries in 22 patients (7 men and 15 women) operated on between 1998 and 2011. Patients with trauma or malignancies were excluded. The mean age of the patients at the time of revision surgery was 56 years (range 20-80 years). The complications were analyzed depending on the operative level and the time between the index surgery and the revision. Results Six major complications (five intraoperatively and one postoperatively) occurred in five patients (20 %): three vein lacerations (12 %) and two ureteral injuries (8 %), despite the presence of a double-J ureteral stent. The three vein damages were repaired or ligated by a vascular surgeon. One of the two ureteral injuries led to a secondary nephrectomy after end-to-end anastomosis failure; the other necessitated secondary laparotomy for small bowel obstruction. Conclusions Anterior revision of the lumbar spine is technically challenging and is associated with a high rate of vascular or urologic complications. Therefore, the potential complications of the procedure must be weighted against its benefits. When iterative anterior lumbar approach is mandatory, exposure should be performed by an access surgeon in specialized centers that have ready access to vascular and urologic surgeons.

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Video-Assisted Versus Open Anterior Lumbar Spine Fusion Surgery

Cited by 45 publications

References 24 publications

Methods and Complications of Anterior Exposure of the Thoracic and Lumbar Spine

Methods and Complications of Anterior Exposure of the Thoracic and Lumbar Spine

Minimally invasive thoracoscopic approach to thoracolumbar junction fractures

Analysis of intraoperative difficulties and management of operative complications in revision anterior exposure of the lumbar spine: a report of 25 consecutive cases

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