Incidence of Vascular Complications Arising from Anterior Spinal Surgery in the Thoraco-Lumbar Spine.
- Author:
Zdenek KLEZL
1
;
Girish Nanjunda SWAMY
;
Thomas VYSKOCIL
;
Jan KRYL
;
Jan STULIK
Author Information
- Publication Type:Original Article
- Keywords: Anterior thoraco-lumbar approach; Complications; Vascular injury; Left iliac vein; External iliac vein
- MeSH: Biocompatible Materials; Decompression; Humans; Iliac Vein; Incidence*; Prospective Studies; Retrospective Studies; Spinal Canal; Spine*; Vascular System Injuries
- From:Asian Spine Journal 2014;8(1):59-63
- CountryRepublic of Korea
- Language:English
- Abstract: STUDY DESIGN: Modern biomaterials and instrumentation have popularised surgery of the thoraco-lumbar spine through an anterior route. The advantage of anterior surgery is that it allows for a direct decompression of the compromised spinal canal. However, the potential for devastating long-term sequelae as a result of complications is high. PURPOSE: The aim of this study was to give a general overview and identify the incidence of vascular complications. OVERVIEW OF LITERATURE: There is limited literature describing the overall incidence and complications of anterior spinal surgery. METHODS: A retrospective review of a prospective database of 1,262 consecutive patients with anterior surgery over a twelve-year period. RESULTS: In our study, 1.58% (n=20) of patients suffered complications. Injury to a major vessel was encountered in 14 (1.11%) cases, of which nine involved an injury to the common iliac vein. In six cases, the original procedure was abandoned due to a life-threatening vascular injury (n=3) and unfavourable anatomy (n=3). CONCLUSIONS: The incidence of vascular and other complications in our study was relatively low. Nevertheless, the potential for devastating long-term sequelae as a result of complications remains high. A thorough knowledge and awareness of normal and abnormal anatomy should be gained before attempting such a procedure, and a vascular surgical assistance especially should be readily accessible. We believe use of access surgeons is mandatory in cases with difficult or aberrant anatomy.
