An analysis of general surgery–related complications in a series of 412 minilaparotomic anterior lumbosacral procedures
Authors:
- 1 January 2009
- journal article
- Published by Journal of Neurosurgery Publishing Group (JNSPG) in Journal of Neurosurgery: Spine
- Vol. 10 (1) , 60-65
Abstract
Object: Anterior lumbar surgery is associated with certain perioperative visceral and vascular complications. The aim of this study was to document all general surgery–related adverse events and complications following minilaparotomic retroperitoneal lumbar procedures and to discuss strategies for their management or prevention. Methods: The authors analyzed data obtained in 412 patients who underwent anterior lumbosacral surgery between 2003 and 2005. The series comprised 114 men and 298 women whose mean age was 56 years (range 34–79 years). Preoperative diagnoses were as follows: isthmic spondylolisthesis (32%), degenerative spondylolisthesis (24%), instability/stenosis (15%), degenerative disc disease (15%), failed–back surgery syndrome (7%), and lumbar degenerative kyphosis or scoliosis (7%). A single level was exposed in 264 patients (64%), 2 in 118 (29%), and 3 or 4 in 30 (7%). The average follow-up period was 16 months. Results: Overall, 52 instances of complications and adverse events occurred in 50 patients (12.1%), including sympathetic dysfunction in 25 (6.06%), vascular injury repaired with/without direct suture in 12 (2.9%), ileus lasting > 3 days in 5 (1.2%), pleural effusion in 4 (0.97%), wound dehiscence in 2 (0.49%), symptomatic retroperitoneal hematoma in 2 (0.49%), angina in 1 (0.24%), and bowel laceration in 1 patient (0.24%). There was no instance of retrograde ejaculation in male patients, and most complications had no long-term sequelae. Conclusions: This report presents a detailed analysis of complications related to anterior lumbar surgery. Although the incidence of complications appears low considering the magnitude of the procedure, surgeons should be aware of these potential complications and their management.Keywords
This publication has 33 references indexed in Scilit:
- An evaluation of vascular anatomy for minilaparotomic anterior L4–5 proceduresJournal of Neurosurgery: Spine, 2006
- Revision surgery of the lumbar spine: anterior lumbar interbody fusion followed by percutaneous pedicle screw fixationJournal of Neurosurgery: Spine, 2006
- Retrograde Ejaculation After Anterior Lumbar Interbody FusionSpine, 2003
- A Prospective Comparison of Surgical Approach for Anterior L4–L5 FusionSpine, 2000
- The Bagby and Kuslich Method of Lumbar Interbody FusionSpine, 1998
- Extraperitoneal Approach to the Lumbar Spine With Video AssistanceSpine, 1996
- Vascular Injury in Anterior Lumbar SurgerySpine, 1993
- Anterior Lumbar Interbody Fusion for Internal Disc DisruptionSpine, 1992
- Sexual Complications of Anterior Fusion of the Lumbar SpineSpine, 1984
- The Management of Rigid Spinal CurvesClinical Orthopaedics and Related Research, 1973