Acta Ortopédica Mexicana

Lazannec JY, Ramares S, Del Vecchio R, Saillant G
Minimal retroperitoneal anterior approach for operating spine from T-12 to S-1: anatomical basis and surgical applications
Acta Ortop Mex 2000; 14 (1)

Language: Español
References: 48
Page: 66-76
PDF: 532.20 Kb.

[Fulltext - PDF]

ABSTRACT

Main objective of the present paper is the description of an anterior retro-peritoneal approach with a gentle renal and pancreato-duodenal mobilization for operating the T-12 to S-1 spine levels, as well as the description of a left anterior approach for lumbar spine is special attention to the lumbar veins and conexions between left renal vein and acigos.
Anatomical dissections in cadavera and surgical approaches in 94 patients who had either injuries or degenerative diseases of the lumbar spine, allowed the autors to establish the highlights of the present technique.
Good results were obtained in all patients, even in those who had previous intra-peritoneal operations and no complications occurred for kidneys, urethers, splen, hypogastric plexus or duodeno-pancreatic union. Operating time, blood loss, possibilities of decortication and the positioning of bone grafting are reported.
It is concluded that advantages of the present technique are greater for lumbar spine than those provided by laparoscopy. There is no significant risk of damage for muscles. Reduction maneuvers are easy. Suspension arthrodesis and short fusion in discectomy and in scoliosis are easy as well. There is no risk of neural damage or gross bleeding as it frequently occurs in classical PLIF.


Key words: lumbar spine, rethroperitoneal, surgery, technique, anterior approach.


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