The use of computed tomography angiography to define the prevertebral vascular anatomy prior to anterior lumbar procedures.
METHODS
Prospective cohort.


OBJECTIVE
To determine the efficacy of a single-slice computed tomography (CT) angiogram to define the prevertebral anatomy in patients undergoing an anterior lumbar spine procedure.


BACKGROUND
Preoperative planning with precise prevertebral anatomic details can help in mini-open anterior lumbar approaches.


METHODS
A total of 76 consecutive patients undergoing a minimal incision approach for anterior lumbar surgery were evaluated before surgery with CT angiography. The prevertebral anatomy was documented, and the patients were observed during treatment.


RESULTS
There were no complications related to CT angiography. This study directly influenced surgical decision making and the treatment options in 21% of patients. The vena caval confluence limited access to the L5-S1 disc in 3% of patients and at the L4-L5 disc in 92% of the patients. Prevertebral anatomic anomalies were found in 11.8% of patients. Atherosclerotic disease was discovered in 17% of the patients. The major complication rate was 7.5%. CT angiography correlated with intraoperative vascular anatomy in all cases.


CONCLUSIONS
Preoperative CT angiography before anterior approaches was determined to be effective in evaluating the prevertebral vascular anatomy.
Datta
Jason C
JC
Spine Education Research Institute, Denver, CO 80229, USA. jcdatta@yahoo.com
Janssen
Michael E
ME
Beckham
Ruth
R
Ponce
Caroline
C
D000792:Angiography / Q000379:methods; D006801:Humans; D007403:Intervertebral Disc / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery; D008159:Lumbar Vertebrae / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000601:surgery; D011300:Preoperative Care / Q000379:methods*; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*