Abdominal Arterial Translation in Lower Lumbar Spine Level Due to Positional Change: A Clinical Survey Using Intraoperative Computed Tomography
<b>Background</b>: Abdominal vascular injury, a fatal complication of lumbar disc surgery, should concern spine surgeons. This study aimed to compare the position of the abdominal arteries in the supine and prone positions and the factors involved. Thirty patients who underwent lumbar su...
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MDPI AG
2024-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/7/1897 |
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| author | Toru Asari Kanichiro Wada Eiji Sasaki Gentaro Kumagai Sunao Tanaka Yasuyuki Ishibashi |
| author_facet | Toru Asari Kanichiro Wada Eiji Sasaki Gentaro Kumagai Sunao Tanaka Yasuyuki Ishibashi |
| author_sort | Toru Asari |
| collection | DOAJ |
| description | <b>Background</b>: Abdominal vascular injury, a fatal complication of lumbar disc surgery, should concern spine surgeons. This study aimed to compare the position of the abdominal arteries in the supine and prone positions and the factors involved. Thirty patients who underwent lumbar surgery by posterior approach were included. <b>Methods</b>: All patients underwent computed tomography (CT) preoperatively in the supine position and intraoperatively in the prone position. In the CT axial image, at the L4, L4/5 disc, L5, and L5/S1 disc level, we measured the shortest distance between the abdominal arteries and the vertebral body (SDA: shortest distance to the aorta), and the amount of abdominal arterial translation, defined as “SDA on intraoperative CT” minus “SDA on preoperative CT”. Additionally, the preoperative CT axial images were evaluated for the presence of aortic calcification. <b>Results</b>: No significant difference in SDA values based on patients’ positions was observed at each level. In males, the supine position brought the abdominal artery significantly closer to the spine at the left side of the L5/S level (<i>p</i> = 0.037), and, in cases of calcification of the abdominal artery, the abdominal artery was found to be closer to the spine at the left side of the L4/5 level (<i>p</i> = 0.026). <b>Conclusions</b>: It is important to confirm preoperative images correctly to prevent great vessel injuries in lumbar spine surgery using a posterior approach. |
| first_indexed | 2024-04-24T10:41:58Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-04-24T10:41:58Z |
| publishDate | 2024-03-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-1c2ec4562a5c483eb4eca00fd01b46d72024-04-12T13:20:57ZengMDPI AGJournal of Clinical Medicine2077-03832024-03-01137189710.3390/jcm13071897Abdominal Arterial Translation in Lower Lumbar Spine Level Due to Positional Change: A Clinical Survey Using Intraoperative Computed TomographyToru Asari0Kanichiro Wada1Eiji Sasaki2Gentaro Kumagai3Sunao Tanaka4Yasuyuki Ishibashi5Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Aomori, JapanDepartment of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Aomori, JapanDepartment of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Aomori, JapanDepartment of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Aomori, JapanDepartment of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Aomori, JapanDepartment of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Aomori, Japan<b>Background</b>: Abdominal vascular injury, a fatal complication of lumbar disc surgery, should concern spine surgeons. This study aimed to compare the position of the abdominal arteries in the supine and prone positions and the factors involved. Thirty patients who underwent lumbar surgery by posterior approach were included. <b>Methods</b>: All patients underwent computed tomography (CT) preoperatively in the supine position and intraoperatively in the prone position. In the CT axial image, at the L4, L4/5 disc, L5, and L5/S1 disc level, we measured the shortest distance between the abdominal arteries and the vertebral body (SDA: shortest distance to the aorta), and the amount of abdominal arterial translation, defined as “SDA on intraoperative CT” minus “SDA on preoperative CT”. Additionally, the preoperative CT axial images were evaluated for the presence of aortic calcification. <b>Results</b>: No significant difference in SDA values based on patients’ positions was observed at each level. In males, the supine position brought the abdominal artery significantly closer to the spine at the left side of the L5/S level (<i>p</i> = 0.037), and, in cases of calcification of the abdominal artery, the abdominal artery was found to be closer to the spine at the left side of the L4/5 level (<i>p</i> = 0.026). <b>Conclusions</b>: It is important to confirm preoperative images correctly to prevent great vessel injuries in lumbar spine surgery using a posterior approach.https://www.mdpi.com/2077-0383/13/7/1897complication of lumbar surgerylumbar surgery with posterior approachabdominal arterial positionintraoperative computed tomographypreoperative computed tomographyO-arm<sup>®</sup> |
| spellingShingle | Toru Asari Kanichiro Wada Eiji Sasaki Gentaro Kumagai Sunao Tanaka Yasuyuki Ishibashi Abdominal Arterial Translation in Lower Lumbar Spine Level Due to Positional Change: A Clinical Survey Using Intraoperative Computed Tomography Journal of Clinical Medicine complication of lumbar surgery lumbar surgery with posterior approach abdominal arterial position intraoperative computed tomography preoperative computed tomography O-arm<sup>®</sup> |
| title | Abdominal Arterial Translation in Lower Lumbar Spine Level Due to Positional Change: A Clinical Survey Using Intraoperative Computed Tomography |
| title_full | Abdominal Arterial Translation in Lower Lumbar Spine Level Due to Positional Change: A Clinical Survey Using Intraoperative Computed Tomography |
| title_fullStr | Abdominal Arterial Translation in Lower Lumbar Spine Level Due to Positional Change: A Clinical Survey Using Intraoperative Computed Tomography |
| title_full_unstemmed | Abdominal Arterial Translation in Lower Lumbar Spine Level Due to Positional Change: A Clinical Survey Using Intraoperative Computed Tomography |
| title_short | Abdominal Arterial Translation in Lower Lumbar Spine Level Due to Positional Change: A Clinical Survey Using Intraoperative Computed Tomography |
| title_sort | abdominal arterial translation in lower lumbar spine level due to positional change a clinical survey using intraoperative computed tomography |
| topic | complication of lumbar surgery lumbar surgery with posterior approach abdominal arterial position intraoperative computed tomography preoperative computed tomography O-arm<sup>®</sup> |
| url | https://www.mdpi.com/2077-0383/13/7/1897 |
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