J Korean Soc Spine Surg.  2002 Dec;9(4):341-346. 10.4184/jkss.2002.9.4.341.

Laparoscopy Assisted Miniopen Lateral Approach for Anterior Lumbar Interbody Fusion

• Lee CS
• Chung SS
• Chung KH

• KMID: 2209716
• DOI: http://doi.org/10.4184/jkss.2002.9.4.341

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.

Keyword

Lumbar spine; Laparoscopy; Miniopen lateral approach; Interbody fusion

MeSH Terms

Hematoma
Humans
Laparoscopy*
Learning Curve
Length of Stay
Lumbosacral Plexus
Paralysis
Pneumonia

Figure

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  Fig. 1. Incision line between the center of upper vertebral body and center of lower vertebral body under fluoroscopic guided

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  Fig. 2. Abdominopelvic CT demonstrating the planes of miniopen lateral approach

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  Fig. 3. Malpositioning of cage due to obstruction of high iliac crest

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