Mini-open anterior lumbar interbody fusion

In deformity surgery, anterior lumbar interbody fusion provides excellent biomechanical support, creates a broad surface area for arthrodesis, and induces lordosis in the lower lumbar spine. Preoperative MRI, plain radiographs, and, when available, CT scan should be carefully assessed for sacral slope as it relates to pubic symphysis, position of the great vessels (especially at L4/5), disc space height, or contraindication to an anterior approach. This video demonstrates the steps in an anterior surgical procedure with minimal open exposure.The video can be found here: https://youtu.be/r3bC4_vu1hQ.

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Mini-open approach to the spine for anterior lumbar interbody fusion

The Spine Journal ◽

10.1016/s1529-9430(02)00184-5 ◽

2002 ◽

Vol 2 (3) ◽

pp. 216-223 ◽

Cited By ~ 177

Author(s):

Salvador A Brau

Keyword(s):

Interbody Fusion ◽

Anterior Lumbar Interbody Fusion ◽

Open Approach ◽

Lumbar Interbody Fusion ◽

Mini Open

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Anterior Lumbar Interbody Fusion (ALIF): Technique Video: 2-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opaa132 ◽

2020 ◽

Vol 19 (4) ◽

pp. E404-E404 ◽

Cited By ~ 1

Author(s):

Pingguo Duan ◽

Jeremy M V Guinn ◽

Brenton Pennicooke ◽

Ratnesh N Mehra ◽

Chih-Chang Chang ◽

...

Keyword(s):

Surface Area ◽

Interbody Fusion ◽

Ventral Surface ◽

Surgical Anatomy ◽

Anterior Lumbar Interbody Fusion ◽

Direct Access ◽

Lumbar Interbody Fusion ◽

Disc Space ◽

Implant Size ◽

Segmental Lordosis

Abstract This surgical video demonstrates the technique of an anterior lumbar interbody fusion (ALIF). This video demonstrates the surgical approach, technical nuances of ALIF, and pearls. The main surgical anatomy and approach-related risks are discussed. The video demonstrates the nuances of ALIF, discussing the importance of the release of the disc space to allow for height restoration and lordosis, endplate preparation to enhance arthrodesis, and choice of implant size. The incision is made via a left paramedian approach with a retroperitoneal dissection and mobilization of the vasculature for access to the disc space. The ALIF provides direct access to the ventral surface of the exposed disc, allowing for an incision of the anterior longitudinal ligament, bilateral release of the annulus fibrosus, and access to a large surface area of the vertebral endplate. This anterior access allows for the placement of implants with a greater surface area for fusion, and this facilitates restoration of segmental lordosis, disc height improvement, and foraminal height increase. We have received informed consent from this patient for the video of this case.

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Circumferential staged open L4–S1 posterior reduction, S1 dome osteotomy followed by mini-open anterior lumbar interbody fusion using bone morphogenetic protein (BMP-2) for high-grade lumbosacral isthmic spondylolisthesis (HGLIS)

The Spine Journal ◽

10.1016/j.spinee.2016.01.118 ◽

2016 ◽

Vol 16 (4) ◽

pp. S83

Author(s):

Erlick Pereira ◽

Arish Rehman ◽

Khai Lam

Keyword(s):

Bone Morphogenetic Protein ◽

Interbody Fusion ◽

Anterior Lumbar Interbody Fusion ◽

High Grade ◽

Lumbar Interbody Fusion ◽

Isthmic Spondylolisthesis ◽

Morphogenetic Protein ◽

Dome Osteotomy ◽

Mini Open

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Dissection of left iliac artery during anterior lumbar interspace fusion: Report of a case

Vascular ◽

10.1177/1708538114534235 ◽

2014 ◽

Vol 23 (2) ◽

pp. 176-178 ◽

Cited By ~ 1

Author(s):

Uwe M Fischer ◽

Mark G Davies ◽

Hosam El Sayed

Keyword(s):

Iliac Artery ◽

Interbody Fusion ◽

Limb Ischemia ◽

Anterior Lumbar Interbody Fusion ◽

Artery Dissection ◽

Acute Limb Ischemia ◽

Vascular Injuries ◽

Lumbar Interbody Fusion ◽

Left Common Iliac Artery ◽

Great Vessels

Vascular injury is an uncommon complication of spine surgery. Among the different approaches, anterior lumbar interbody fusion has increased potential for vascular injuries, since the great vessels and their branches overly the disc spaces to be operated on, and retraction of these vessels is necessary to gain adequate surgical exposure. The reported incidence for anterior lumbar interbody fusion-associated vascular injuries ranges from 0% to 18.1%, with venous laceration as the most common type. We report a case of anterior lumbar interbody fusion-associated left common iliac artery dissection leading to delayed acute limb ischemia developing in early post-operative period.

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Lymphocele formation after anterior lumbar interbody fusion at L4–5

Journal of Neurosurgery Spine ◽

10.3171/spi-07/11/566 ◽

2007 ◽

Vol 7 (5) ◽

pp. 566-570 ◽

Cited By ~ 9

Author(s):

Yong Hun Pee ◽

Ki Joon Kim ◽

Young-Geun Choi ◽

Sang Hyeop Jeon ◽

Jong Dae Park ◽

...

Keyword(s):

Interbody Fusion ◽

Rare Complication ◽

Anterior Lumbar Interbody Fusion ◽

Lumbar Interbody Fusion ◽

Lumbar Spinal ◽

Lower Lumbar

✓ In this report, the authors present the case of patient with a lymphocele in the retroperitoneal area following anterior lumbar interbody fusion at L4–5. A lymphocele is a rare complication of spinal operations, especially lower lumbar spinal surgeries. The authors discuss this complicating factor and describe its features and treatments.

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5:5643. Anterior Lumbar Interbody Fusion for Degenerative Disc Disease: A Stratified Patient Population With Preoperative MRI Findings of Disc Space Collapse and Cartilaginous End Plate Erosion

The Spine Journal ◽

10.1016/j.spinee.2006.06.061 ◽

2006 ◽

Vol 6 (5) ◽

pp. 21S

Author(s):

Peter Ullrich ◽

David DeWitt ◽

Pamela Verkuilen ◽

Sherry Meyer

Keyword(s):

Degenerative Disc Disease ◽

Patient Population ◽

Interbody Fusion ◽

Anterior Lumbar Interbody Fusion ◽

Lumbar Interbody Fusion ◽

Mri Findings ◽

Disc Disease ◽

Disc Space ◽

Degenerative Disc ◽

End Plate

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Oblique Lumbar Interbody Fusion at the L5-S1 Segment via an Approach Between the Psoas Muscle and the Great Vessels: Technique Note and Case Presentations.

10.21203/rs.3.rs-125260/v1 ◽

2020 ◽

Author(s):

Xigong Li ◽

Weiyi Diao ◽

Yuzhu Zhang ◽

Junsong Wu ◽

Chunyang Xing ◽

...

Keyword(s):

Interbody Fusion ◽

Perioperative Complications ◽

Psoas Muscle ◽

Common Iliac Vein ◽

Type I ◽

Lumbar Interbody Fusion ◽

Disc Space ◽

Type Iii ◽

Great Vessels ◽

Oblique Lumbar Interbody Fusion

Abstract Study DesignTechnique note.ObjectivesTo describe our modified oblique lumbar interbody fusion (OLIF) technique in the reconstruction of the L5-S1 segment.Summary of Background DataRecently, OLIF has been generally recognized as an effective procedure in the treatment of various spinal pathologies at L2-L5 segments. However, the usage of OLIF at the L5-S1 segment doesn’t have gained widespread acceptance in spine community. Some authors still concern about the feasibility of OLIF used in lumbosacral fusionMethodsTen consecutive patients underwent L5-S1 interbody fusion using the OLIF technique in our institution. The L5–S1 disc space is approached via one retroperitoneal oblique corridor between the psoas muscle and the great vessels. The discectomy and endplate preparation are performed through a surgical window developed on the anterolateral side of L5-S1 disc. A secondary cage insertion technique is used for safe placement of interbody fusion cages.ResultsOf the 10 patients, 6 were males and 4 were females, with an average age of 55.4±6.8 years. There were 8 single-level and 2 two-level procedures, including 2 at L4–L5 and 10 at L5–S1. Preoperative axial MR images confirmed 1 patient with type I LCIV (left common iliac vein), 6 with type II LCIV and 3 with type III LCIV. The average blood loss was 133.4±88.5 ml, and the average operative times were 153.6±38.3 minutes. Postoperative radiographs examination confirmed all patients obtained a better reconstruction at the lumbosacral junction. Two patients with type III LCIV sustained iliolumbar vein laceration during the exposure, and no other perioperative complications were encountered.ConclusionOur novel OLIF L5-S1 technique is a more feasible procedure of lumbosacral fusion, which shared the common surgical plane with OLIF L2-5, allowing for L2 to S1 reproducible multi-levels interbody fusions via a retroperitoneal oblique corridor between the psoas muscle and the great vessels. Detailed preoperative plan and meticulous intraoperative manipulation are prerequisite for the success of OLIF L5-S1 procedure.

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