Authors: Janina Kueper Gary A Fantini Brendon R Walker Alexander Aichmair Alexander P Hughes
Publish Date: 2015/02/10
Volume: 24, Issue: 4, Pages: 800-809
Abstract
A total of 900 patients who underwent a LLIF at an average 194 levels range 1–5 levels by one of six fellowship trained surgeons on 1754 levels from 2006 to 2013 were identified The incidence of intraoperative vascular injury was retrospectively determined from the Operative Records The management of vascular injury was evaluated The miniopen access adapted by our institution for LLIF is describedThe incidence of major vascular complication in our series was 1/900 The incidence of minor vascular injury was 4/900 The overall incidence of vascular injury was calculated to be 0056 per case and 0029 per level All minor vascular injuries were identified to be segmental vessel lacerations which were readily ligated under direct visualization without further extension of the incision with no clinical sequelae The laceration of the abdominal aorta the major vascular complication of this series was emergently repaired through an exploratory laparotomy None of the patients suffered longterm sequelae from their intraoperative vascular injuriesThe miniopen lateral access technique for LLIF provides for minimal risk of vascular injury to the lumbar spine In the rare event of minor vascular injury the miniopen access approach allows for immediate visualization confirmation and repair of the vessel with no longterm sequelae
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