Effect of Anatomic Variability and Level of Approach on Perioperative Vascular Complications With Anterior Lumbar Interbody Fusion

Spine
Ardalan Alen NourianRobert K Eastlack

Abstract

Retrospective review of prospectively collected data. The study aim was to determine the prevalence of vascular complications associated with anterior lumbar interbody fusion (ALIF) as a function of anatomic variation and the number of levels fused. ALIF often requires mobilization of the great vessels, particularly when exposing levels above L5-S1. The exposure can be more challenging in the setting of spondylolisthesis or transitional anatomy. This retrospective review of prospectively collected data from our spine database identified 204 patients who had undergone single level (n = 142) or multilevel (n = 62) ALIF from 2008 to 2013 with minimum 6-month follow-up. Average age was 58 years; 57% were female. Preoperative radiographic assessment for spondylolisthesis and transitional anatomy was performed. Body mass index, estimated blood loss, and levels of ALIF were recorded. Intraoperative vascular injury, postoperative deep venous thrombosis, and pulmonary embolism events were noted. Eleven patients experienced postoperative thromboembolic events and were more likely to have had intraoperative vascular injury compared with patients who did not develop a vascular complication (36% and 5%, respectively; P = 0.004). Estimated b...Continue Reading

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Citations

Oct 28, 2017·Current Reviews in Musculoskeletal Medicine·Peter B Derman, Todd J Albert
Sep 14, 2017·Clinical Spine Surgery : a Spine Publication·Nam-Su ChungHan-Dong Lee
Dec 20, 2017·Spine Surgery and Related Research·Tokumi KanemuraShiro Imagama
Jan 27, 2018·Spine Surgery and Related Research·Shigeto EbataHirotaka Haro
Aug 17, 2020·Journal of Vascular Surgery. Venous and Lymphatic Disorders·Vy T HoVenita Chandra
Nov 6, 2020·The Spine Journal : Official Journal of the North American Spine Society·Olivier Q GrootJoseph H Schwab

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