An evaluation of vascular anatomy for minilaparotomic anterior L4–5 procedures

Kang, Byung-Uk; Lee, Sang-Ho; Jeon, Sang-Hyeop; Park, Jong Dae; Maeng, Dae Hyeon; Choi, Young Geun; Tsang, Yi-Sheng

doi:10.3171/spi.2006.5.6.508

Cited by 9 publications

(4 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As occurred in our cases, Kothbauer and Seiler reported transdural nerve root incarceration after microsurgical lumbar discectomy 5) . In 1994, Toppich et al reported complications similar to that case 9) .…”

Section: Discussionsupporting

confidence: 78%

“…These studies tell us that unrelieved trapped roots have a high possibility of incarcerating themselves in much the same manner that bowel loops are incarcerated in an abdominal wall hernia. The ischemic damage led to progressive pain and sensory motor deficit 5,9) ; however, no morbidity was associated with these events when the dura was adequately closed, primarily with sutures . Several investigators have reported the prevalence of unintended dural tears during lumbar spine surgery with variable incidences ranging from 1-17% 2,10) .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Therapeutic Strategy of Transdural Nerve Root Herniation during Anterior Lumbar Interbody Fusion: Report of Two Cases

Lee

Ahn

2018

J Minim Invasive Spine Surg Tech

View full text Add to dashboard Cite

We report two cases of transdural nerve root herniation caused by incidental dural tear during anterior lumbar interbody fusion. We also describe how these unexpected complications were managed. Two patients suffered from degenerative spondylolisthesis and foraminal stenosis with a redundant dural sac. In these patients, the dural tears occurred during anterior discectomy and the nerve roots subsequently herniated outward because of intradural pressure. The herniated neural tissues were restored via a posterior transdural approach. There is always the possibility of a dural tear with nerve root herniation during surgery employing an anterior lumbar approach. If this occurs, we should be aware of the difficulty in repairing the dura from this approach. We should also keep in mind that adequate repair of it is important to avoid related postoperative complication.

show abstract

Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Surgical Therapeutic Strategy of Transdural Nerve Root Herniation during Anterior Lumbar Interbody Fusion: Report of Two Cases

Lee

Ahn

2018

J Minim Invasive Spine Surg Tech

View full text Add to dashboard Cite

show abstract

“…Our technique for the anterior approach has been described in detail elsewhere. 12 For single-and multilevel procedures, we used a left-sided, muscle-preserving technique, retracting the rectus muscle superolaterally. The peritoneal contents were placed rostrally using a robotic arm retractor, and vascular dissection was performed with dissecting swabs and a hand-held retractor.…”

Section: Surgical Techniquementioning

confidence: 99%

An analysis of general surgery–related complications in a series of 412 minilaparotomic anterior lumbosacral procedures

Kang

Choi

Lee

et al. 2009

SPI

Self Cite

View full text Add to dashboard Cite

Object Anterior lumbar surgery is associated with certain perioperative visceral and vascular complications. The aim of this study was to document all general surgery–related adverse events and complications following minilaparotomic retroperitoneal lumbar procedures and to discuss strategies for their management or prevention. Methods The authors analyzed data obtained in 412 patients who underwent anterior lumbosacral surgery between 2003 and 2005. The series comprised 114 men and 298 women whose mean age was 56 years (range 34–79 years). Preoperative diagnoses were as follows: isthmic spondylolisthesis (32%), degenerative spondylolisthesis (24%), instability/stenosis (15%), degenerative disc disease (15%), failed–back surgery syndrome (7%), and lumbar degenerative kyphosis or scoliosis (7%). A single level was exposed in 264 patients (64%), 2 in 118 (29%), and 3 or 4 in 30 (7%). The average follow-up period was 16 months. Results Overall, 52 instances of complications and adverse events occurred in 50 patients (12.1%), including sympathetic dysfunction in 25 (6.06%), vascular injury repaired with/without direct suture in 12 (2.9%), ileus lasting > 3 days in 5 (1.2%), pleural effusion in 4 (0.97%), wound dehiscence in 2 (0.49%), symptomatic retroperitoneal hematoma in 2 (0.49%), angina in 1 (0.24%), and bowel laceration in 1 patient (0.24%). There was no instance of retrograde ejaculation in male patients, and most complications had no long-term sequelae. Conclusions This report presents a detailed analysis of complications related to anterior lumbar surgery. Although the incidence of complications appears low considering the magnitude of the procedure, surgeons should be aware of these potential complications and their management.

show abstract

“…8 -11 Many researchers have already realized the importance of preoperative assessment of the prevertebral vascular structures and have studied the optimal trajectories to the spine that aid in the mobilization of major vessels and prevention of vascular injury. [12][13][14][15][16] Previous recommendations for optimal trajectories were generally based on the structural aspect of vascular mobilization. However, the tension in the vascular structure is also an important factor to be considered for adequate exposure of a target lesion.…”

mentioning

confidence: 99%

Changes in Abdominal Vascular Tension Associated With Various Leg Positions in the Anterior Lumbar Approach

Kim

Kwak²,

Jeun³

et al. 2010

Spine

View full text Add to dashboard Cite

show abstract

An evaluation of vascular anatomy for minilaparotomic anterior L4–5 procedures

Abstract: Careful preoperative evaluation of the vascular anatomy is essential to conducting successful anterior lumbar surgery. The determination of an appropriate approach can contribute to a reduction of unnecessary vascular retraction and a consequent decrease in vascular complications.

Cited by 9 publications

References 41 publications

Surgical Therapeutic Strategy of Transdural Nerve Root Herniation during Anterior Lumbar Interbody Fusion: Report of Two Cases

Surgical Therapeutic Strategy of Transdural Nerve Root Herniation during Anterior Lumbar Interbody Fusion: Report of Two Cases

An analysis of general surgery–related complications in a series of 412 minilaparotomic anterior lumbosacral procedures

Changes in Abdominal Vascular Tension Associated With Various Leg Positions in the Anterior Lumbar Approach

Contact Info

Product

Resources

About