Asian Spine J.  2014 Feb;8(1):59-63. 10.4184/asj.2014.8.1.59.

Incidence of Vascular Complications Arising from Anterior Spinal Surgery in the Thoraco-Lumbar Spine

• Klezl Z
• Swamy GN
• Vyskocil T
• Kryl J
• Stulik J

• KMID: 2270389
• DOI: http://doi.org/10.4184/asj.2014.8.1.59

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.

Keyword

Anterior thoraco-lumbar approach; Complications; Vascular injury; Left iliac vein; External iliac vein

MeSH Terms

Biocompatible Materials
Decompression
Humans
Iliac Vein
Incidence*
Prospective Studies
Retrospective Studies
Spinal Canal
Spine*
Vascular System Injuries
Biocompatible Materials