Laparoscopic approach for lumbar spinal fusion.
Several recent articles suggest that utilization of the laparoscopic anterior lumbar interbody fusion (ALIF) is decreasing in this country. After reviewing the published evidence in support and in opposition to this approach, we felt that the topic warranted additional study. We began a prospective study utilizing the known techniques to help reduce serious complications. These techniques were previously reported but not widely utilized according to the available literature. We report our early results of eleven patients along with a detailed description of the approach itself with the emphasis aimed at the laparoscopic approach surgeon. One patient was converted to open, with adequate exposure achieved in all. No bleeding complications were seen. Early postoperative results are encouraging. Our conclusions are that the laparoscopic anterior approach to the lumbar spine can be safely performed by approach-surgeons skilled in advanced laparoscopic techniques and those who have also received additional training in laparoscopic anterior lumbar exposures. We feel that improvement over the open approach may be achievable with increased experience.
Nepomnayshy
Dmitry
D
Department of General Surgery, Orthopedic Surgery and Neurosurgery, Lahey Clinic, Burlington, MA 01805, USA. dmitry.nepomayshy@lahey.org
Cross
Shimae
S
Pfeifer
Bernard
B
Magge
Subu
S
D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008159:Lumbar Vertebrae / Q000601:surgery*; D011446:Prospective Studies; D013123:Spinal Fusion / Q000379:methods*