title: Anterior approach to the spine. Role of the general surgeon, techniques and surgical complications. The 10-year experience of the Niguarda Hospitals.
abstract: OBJECTIVE
  The aim of the study was to present the incidence of early and late surgical complications in a group of patients treated with anterior approach for spine lesions. The study was also focused on technical aspects for lesions of D1-D2 and L5-S1 segments and results on a group of patients underwent adjunctive surgical procedures at the same time of spinal surgery.
  
  
  METHODS
  This was a retrospective study based on our database from April 1998 to December 2008. The study enrolled 120 consecutive patients (M/F 73/47; mean age 43.1 years; range 15-70 years) who underwent spinal surgery for trauma (92 patients), primitive or metastatic cancer (12 patients), benign lesion (2 patients), degenerative disc disease (6 patients) and infection disease (8 patients). This work describes the anterior approach to the spine.
  
  
  RESULTS
  No death was recorded. Thirty-two patients (26.6%) presented postoperative complications: persistent urinary tract infections in 19 (15.9%), pneumonia in 6 (5%), pleural effusion in 3 (2.5%), wound infection in 2 (1.6%), retro-peritoneal abscess in 1 (0.8%) and haemorrhage in 1 (0.8%). During the follow-up (mean 3.8 years; range 2 months-10 years) 1 patient (0.8%) required two further surgical procedures for tuberculosis abscess recurrences.
  
  
  CONCLUSIONS
  Anterior approach to the spine is effective and safe. Surgical complications do not negatively affect patient survival and spine stabilization included patients with D1-D2 and L5-S1 lesion and patients who receive adjunctive surgery at the same time of spine procedure.
authors.affiliation: Niguarda Ca' Granda Hospital, Milan, Italy. trapiantirenepancreas@ospedaleniguarda.it
authors.forename: C V
authors.initials: CV
authors.lastname: Sansalone
authors.forename: S
authors.initials: S
authors.lastname: Soldano
authors.forename: C
authors.initials: C
authors.lastname: Poli
authors.forename: M
authors.initials: M
authors.lastname: Tripepi
authors.forename: G A
authors.initials: GA
authors.lastname: D'Aliberti
authors.forename: O
authors.initials: O
authors.lastname: Rossetti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D007403:Intervertebral Disc / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013116:Spinal Cord / Q000601:surgery*; D013131:Spine / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery