Authors: Abid Mogannam Christian Bianchi Jason Chiriano Sheela Patel Theodore H Teruya Sharon S Lum Ahmed M AbouZamzam
Publish Date: 2012/12/01
Volume: 147, Issue: 12, Pages: 1130-1134
Abstract
Results Four hundred seventysix patients underwent ARES Mean SD age was 477 126 years 466 had undergone prior abdominal surgery Mean SD body mass index BMI was 283 55 616 of procedures included the L45 disk Mean SD time to exposure was 700 255 minutes Vascular injury occurred in 233 38 major Perioperative complications occurred in 164 of cases Prior abdominal surgery had no effect on time to exposure vascular injury and perioperative complications A BMI of 30 or more had no effect on time to exposure compared with a lower BMI A BMI of 30 or more led to higher rates of vascular injury 308 vs 197 P = 007 and overall complications 214 vs 140 P = 04 Exposures involving L45 led to increased time to exposure 770 vs 562 minutes P 001 and higher rates of vascular injury 297 vs 131 P 001 but had no effect on overall complications compared with exposures for other levelsAnterior retroperitoneal exposure of the lumbar spine ARES is a frequently used technique in the performance of anterior lumbar interbody fusion and lumbar total disk replacement General and vascular surgeons often act as “exposure surgeons” for these cases in a 2team approach with the spine surgeons Lumbar spine operations are increasingly being performed in the United States with spending on lumbar fusion increasing more than 500 in the past decade12 The clinical indications for these procedures are well described for the spine surgeon However for the exposure surgeons the anatomic limitations of the anterior retroperitoneal exposure are not well defined
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