Anterior Retroperitoneal Spine Exposure following Prior Endovascular Aortic Aneurysm Repair

Ullery, Brant W.; Thompson, P. T.; Mell, Matthew W.

doi:10.1016/j.avsg.2016.01.048

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…4 The benefits of spinal reconstruction for patients with symptomatic DDD and radiculopathy are well established in the literature. 5,6 Anterior reconstructions, in particular, have been shown to reduce the risk of neurological complications 5 and morbidity 7 postoperatively in comparison with other approaches. Patients with chronic low back pain (CLBP) due to DDD who have failed to respond to conservative management can benefit from surgical intervention, with both fusion and total disc replacement (TDR) being accepted treatment options.…”

Section: Introductionmentioning

confidence: 99%

Combined Aorto-Iliac and Anterior Lumbar Spine Reconstruction: A Case Series

et al. 2018

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Background: Treatment options for aortic-iliac pathology may include endovascular repair and open surgical repair. Treatment options for degenerative disc disease (DDD) are varied but commonly include anterior reconstruction. When both the aortic-iliac and spinal pathologies are significant and surgical intervention is indicated for each pathology, the opportunity exists for concurrent treatment of both the aortic-iliac pathology and DDD in the same operation. The purpose of this case series was to document the safety and feasibility of a surgical strategy whereby a combined elective reconstructive procedure was performed for aortic and anterior lumbar spinal pathologies.Methods: The case histories of 5 patients who were treated for both spinal and vascular pathology are presented. Surgical outcome measures included operative time, blood loss, length of stay, and complications. Spine-specific outcome measures included Oswestry Disability Index, Roland Morris Disability Questionnaire, and visual analogue scores (back and leg).Results: The spinal reconstructions performed included 1 L4-5 total disc replacement (TDR), 1 L4-5, L5-S1 anterior lumbar interbody fusion (ALIF), 1 L5-S1 ALIF, and 2 hybrid procedures (L4-5 TDR with L5-S1 ALIF). Vascular reconstructions included 4 aorto-bi-iliac bypass grafts and 1 aortic tube graft. The average operative time was 365 minutes (ranging between 330 and 510 minutes), the average blood loss was 1699 mL (range between 1160 and 2960 mL), and the average length of hospital stay was 14 days (range from 8 to 22 days). There were no in-hospital complications, and all patients experienced significant improvement in both back and leg pain. One patient developed kinking of the iliac limbs of the vascular graft 1 year postoperatively, which was managed with endovascular stenting of the graft.Conclusions: Aortic-iliac pathology and DDD are significant pathologies often treated in isolation. This study illustrates that, despite its complexity, highly trained individuals in a specialized setting can perform combined surgery to achieve a satisfactory outcome for the patient.Level of Evidence: Level IV evidence. Lumbar SpineKeywords: abdominal aortic aneurysm, total disc arthroplasty, anterior lumbar interbody fusion, aortic iliac occlusive disease, multidisciplinary approach by guest on July 5, 2020 http://ijssurgery.com/ Downloaded from Abbreviations: VAS, visual analogue score; ODI, Oswestry Disability Index; RMDQ, Roland Morris Disability Questionnaire.

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Section: Introductionmentioning

confidence: 99%

Combined Aorto-Iliac and Anterior Lumbar Spine Reconstruction: A Case Series

et al. 2018

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Arterial Complications

Chin,

Ulloa,

Schoeff

2023

Lumbar Spine Access Surgery

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Rapid, midline retroperitoneal exposure for four-level anterior lumbar interbody fusion—technical case atlas

Falahee

Kahn

Heidenreich

et al. 2021

Journal of Surgical Case Reports

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We describe a novel, rapid midline retroperitoneal operative technique in a patient, with multi-level degenerative scoliosis, who underwent an extensive L2-S1 anterior lumbar interbody fusion in addition to posterior instrumentation. Uniquely, our approach enables an essentially midline approach to the rectus muscle and uses the diminution of the transversalis fascia-to-peritoneum transition in the pelvis to provide expedited exposure—making it particularly helpful for ALIF exposure, retraction and intraoperative radiography. We minimize morbidity around the rectus sheath by dissecting only the medial rectus muscle and then gently, bluntly mobilizing the retroperitoneum from the deep pelvis cranially.

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Anterior Retroperitoneal Spine Exposure following Prior Endovascular Aortic Aneurysm Repair

Cited by 3 publications

References 10 publications

Combined Aorto-Iliac and Anterior Lumbar Spine Reconstruction: A Case Series

Combined Aorto-Iliac and Anterior Lumbar Spine Reconstruction: A Case Series

Arterial Complications

Rapid, midline retroperitoneal exposure for four-level anterior lumbar interbody fusion—technical case atlas

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