Laparoscopy Assisted Miniopen Lateral Approach for Anterior Lumbar Interbody Fusion / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: A new approach to anterior lumbar interbody fusion (ALIF). OBJECTIVE: To investigate the advantages, technical pitfalls and complications of the laparoscopy assisted miniopen lateral approach. SUMMARY OF LITERATURE REVIEW Several kinds of miniopen approach or laparoscopy are now used for ALIF. MATERIALS AND METHODS: Thirty-five patients with various disease entities were included. Blood loss, operation time, incision size, postoperative time to mobilization, length of hospital stay, technical problems and complications were analyzed. RESULTS: Using this approach, T12 to L5 can be reached sub-diaphragmatically. Blood loss and operation time were 45.7 cc and 82.8 minutes for 1 level, 103.2 cc and 107.6 minutes for two levels, 272.5 cc and 150 minutes for three levels, and 520 cc and 190 minutes for four-level-fusion, respectively, The incision sizes were on average 4.1cm for 1 level, 6.2 cm for 2 levels, 8.2 cm for 3 levels and 10.1 cm for four-level-fusion. Complications were retroperitoneal hematoma in 2 cases, pneumonia in 1 case and transient lumbosacral plexus palsy in 3 cases. CONCLUSION: The laparoscopy assisted miniopen lateral approach is an advantageous approach with a very short learning curve. However, special attention is required if complications such as transient lumbosacral plexus palsy are to be avoided.