Intraoperative Complications of the Anterior Retroperitoneal Approach to the Lumbosacral Spine in the Supine Position: A Proposal for an Algorithm to Predict the Degree of Difficulty of the Surgical Procedure
The main concern in anterior exposure of the lumbosacral spine is the risk of vascular injury during mobilization and retraction of the blood vessels. Preoperative planning is considered essential to reducing the incidence of vascular injury, although no consensus has been reached on the preferred m...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Surgical Techniques Development |
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| Online Access: | https://www.mdpi.com/2038-9582/12/4/18 |
| _version_ | 1797358087658536960 |
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| author | Francesco Caiazzo Lucas Capo Juan Bago |
| author_facet | Francesco Caiazzo Lucas Capo Juan Bago |
| author_sort | Francesco Caiazzo |
| collection | DOAJ |
| description | The main concern in anterior exposure of the lumbosacral spine is the risk of vascular injury during mobilization and retraction of the blood vessels. Preoperative planning is considered essential to reducing the incidence of vascular injury, although no consensus has been reached on the preferred methodology for such planning. This is a retrospective study, including all patients operated on by a single surgeon, who received anterior lumbar-spine surgery in the supine position as a primary procedure before undergoing an anterior lumbar interbody fusion (ALIF) or an artificial disc replacement (ADR). The aim of this study was to list the intraoperative complications observed. We included 156 patients (87 women; mean age, 48 years) who met the inclusion criteria. The overall complication rate was 6.4% (10/156). The most frequent complications were an incidental peritoneal opening (seven patients, 4.4%); two left–iliac-vein injuries (1.28%) that were sutured; and one dural tear during a decompression maneuver of the canal. No neurological, arterial, or ureteral injury or retrograde ejaculation was reported. The use of a sound protocol that includes planning, assessment of approach difficulty, and step-by-step surgical technique can reduce the rate of vascular injury in anterior lumbosacral-spine surgery. |
| first_indexed | 2024-03-08T14:54:46Z |
| format | Article |
| id | doaj.art-d8cec77b3313472db43c2fa3061092c4 |
| institution | Directory Open Access Journal |
| issn | 2038-9582 |
| language | English |
| last_indexed | 2024-03-08T14:54:46Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Surgical Techniques Development |
| spelling | doaj.art-d8cec77b3313472db43c2fa3061092c42024-01-10T17:48:15ZengMDPI AGSurgical Techniques Development2038-95822023-10-0112418819810.3390/std12040018Intraoperative Complications of the Anterior Retroperitoneal Approach to the Lumbosacral Spine in the Supine Position: A Proposal for an Algorithm to Predict the Degree of Difficulty of the Surgical ProcedureFrancesco Caiazzo0Lucas Capo1Juan Bago2Instituto Quirúrgico Spano, Clinica Sagrada Familia, 08022 Barcelona, SpainInstituto Quirúrgico Spano, Clinica Sagrada Familia, 08022 Barcelona, SpainInstituto Quirúrgico Spano, Clinica Sagrada Familia, 08022 Barcelona, SpainThe main concern in anterior exposure of the lumbosacral spine is the risk of vascular injury during mobilization and retraction of the blood vessels. Preoperative planning is considered essential to reducing the incidence of vascular injury, although no consensus has been reached on the preferred methodology for such planning. This is a retrospective study, including all patients operated on by a single surgeon, who received anterior lumbar-spine surgery in the supine position as a primary procedure before undergoing an anterior lumbar interbody fusion (ALIF) or an artificial disc replacement (ADR). The aim of this study was to list the intraoperative complications observed. We included 156 patients (87 women; mean age, 48 years) who met the inclusion criteria. The overall complication rate was 6.4% (10/156). The most frequent complications were an incidental peritoneal opening (seven patients, 4.4%); two left–iliac-vein injuries (1.28%) that were sutured; and one dural tear during a decompression maneuver of the canal. No neurological, arterial, or ureteral injury or retrograde ejaculation was reported. The use of a sound protocol that includes planning, assessment of approach difficulty, and step-by-step surgical technique can reduce the rate of vascular injury in anterior lumbosacral-spine surgery.https://www.mdpi.com/2038-9582/12/4/18anterior lumbar interbody fusionALIFintraoperative complicationsvascular injuryADR |
| spellingShingle | Francesco Caiazzo Lucas Capo Juan Bago Intraoperative Complications of the Anterior Retroperitoneal Approach to the Lumbosacral Spine in the Supine Position: A Proposal for an Algorithm to Predict the Degree of Difficulty of the Surgical Procedure Surgical Techniques Development anterior lumbar interbody fusion ALIF intraoperative complications vascular injury ADR |
| title | Intraoperative Complications of the Anterior Retroperitoneal Approach to the Lumbosacral Spine in the Supine Position: A Proposal for an Algorithm to Predict the Degree of Difficulty of the Surgical Procedure |
| title_full | Intraoperative Complications of the Anterior Retroperitoneal Approach to the Lumbosacral Spine in the Supine Position: A Proposal for an Algorithm to Predict the Degree of Difficulty of the Surgical Procedure |
| title_fullStr | Intraoperative Complications of the Anterior Retroperitoneal Approach to the Lumbosacral Spine in the Supine Position: A Proposal for an Algorithm to Predict the Degree of Difficulty of the Surgical Procedure |
| title_full_unstemmed | Intraoperative Complications of the Anterior Retroperitoneal Approach to the Lumbosacral Spine in the Supine Position: A Proposal for an Algorithm to Predict the Degree of Difficulty of the Surgical Procedure |
| title_short | Intraoperative Complications of the Anterior Retroperitoneal Approach to the Lumbosacral Spine in the Supine Position: A Proposal for an Algorithm to Predict the Degree of Difficulty of the Surgical Procedure |
| title_sort | intraoperative complications of the anterior retroperitoneal approach to the lumbosacral spine in the supine position a proposal for an algorithm to predict the degree of difficulty of the surgical procedure |
| topic | anterior lumbar interbody fusion ALIF intraoperative complications vascular injury ADR |
| url | https://www.mdpi.com/2038-9582/12/4/18 |
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