title: Large blood vessel stretch in lumbar spine through anterior surgical approach: An experimental study in adult goat.
abstract: BACKGROUND
  Various anterior lumbar surgical approaches, including the minimally invasive approach, have greatly improved in recent years. Vascular complications resulting from ALIF are frequently reported. Little information is available about the safety of large blood vessel stretch. We evaluated the right side stretch limit (RSSL) of the abdominal aorta (AAA) and the inferior vena cava (IVC) without blood flow occlusion and investigated stretch-induced histological injury and thrombosis in the iliac and femoral arteries and veins and the stretched vessels.
  
  
  METHODS
  The RSSL of blood vessels in five adult goats was measured by counting the number of 0.5-cm-thick wood slabs that were inserted between the right lumbar edge and the stretch hook. Twenty seven adult goats were divided into three groups to investigate histological injury and thrombosis under a stretch to 0.5 cm (group I) 1.5 cm (group II) for 2 h, or no stretch (group III). Blood vessel samples from groups I and II were analyzed on postsurgical days 1, 3, and 7. Thrombogenesis was examined in the iliac and femoral arteries and veins.
  
  
  RESULTS
  The RSSL of large blood vessels in front of L4/5 was 1.5 cm from the right lumbar edge. All goats survived surgery without complications. No injury or thrombosis in the large blood vessels in front of the lumbar vertebrae and in the iliac or femoral arteries and veins was observed. Under light microscopy, group I showed slight swelling of endothelial cells in the AAA and no histological injury of the IVC. The AAA of group II showed endothelial cell damage, unclear organelles, and incomplete cell connections by electron microscopy.
  
  
  CONCLUSIONS
  The AAA and IVC in a goat model can be stretched by ≤0.5 cm, with no thrombosis in the AAA, IVC, iliac or femoral arteries and veins.
authors.affiliation: Department of Orthopedics, Orthopedics Center of PLA, Chongqing, China.
authors.forename: Liehua
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Orthopedics, Orthopedics Center of PLA, Chongqing, China.
authors.forename: Haoming
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Orthopedics Center of PLA, Chongqing, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Pathology, Southwest Hospital, Chongqing, China.
authors.forename: Deyu
authors.initials: D
authors.lastname: Guo
authors.affiliation: Department of Surgically Applied Anatomy and Surgery, Third Military Medical University, Chongqing, China.
authors.forename: Yangjun
authors.initials: Y
authors.lastname: Lan
authors.affiliation: Department of Health Statistics, Third Military Medical University, Chongqing, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
keywords: Adult goat; anterior lumbar approach; large blood vessel stretch; surgical approach
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