Dua Anahita, Fox Jennifer, Patel Bhavin, Martin Eric, Rosner Michael, Fox Charles J
Department of Surgery, Medical College of Wisconsin, Milwaukee, WI; Center for Translational Injury Research (CeTIR), Department of Surgery, University of Texas-Houston.
Department of Surgery, Division of Vascular Surgery.
Vascular. 2014 Aug;22(4):246-51. doi: 10.1177/1708538113478757. Epub 2013 May 7.
We report a five year military experience with anterior retroperitoneal spine exposure combining vascular and neurosurgical spine teams. From August 2005 through April 2010 (56 months), hospital records from a single institution were retrospectively reviewed. Complications, estimated blood loss, transfusions, operative time and length of stay were documented. Eighty-four patients with lumbar spondylosis underwent primary (63, 75%) or secondary exposure (21, 25%) of a single- (66, 79%) or multilevel disc space (18, 21%). Median operative time and estimated blood loss were 127 minutes (range, 30-331 minutes) and 350 mL (range, 0-2940 mL). The overall complication rate was 23.8%. Postoperative complications included six blood transfusions (7%), three patients with retrograde ejaculation (3.57%) or surgical site infection; two with a prolonged ileus (2.38%) or ventral hernia and one each with a bowel obstruction (1, 1.19%), deep venous thrombosis or lymphocele. All-cause mortality was 1%. In conclusion, a team approach can minimize complications while offering the technical benefits and durability of an anterior approach to the lumbar spine.
我们报告了血管外科和神经外科脊柱团队联合进行前路腹膜后脊柱暴露的五年军事经验。从2005年8月至2010年4月（56个月），对单一机构的医院记录进行了回顾性研究。记录了并发症、估计失血量、输血情况、手术时间和住院时间。84例腰椎间盘突出症患者接受了单节段（66例，79%）或多节段椎间盘间隙（18例，21%）的初次（63例，75%）或二次暴露（21例，25%）。中位手术时间和估计失血量分别为127分钟（范围30 - 331分钟）和350毫升（范围0 - 2940毫升）。总体并发症发生率为23.8%。术后并发症包括6例输血（7%）、3例逆行射精（3.57%）或手术部位感染；2例肠梗阻延长（2.38%）或腹疝，1例肠梗阻（1例，1.19%）、深静脉血栓形成或淋巴囊肿。全因死亡率为1%。总之，团队协作方法可以在提供腰椎前路手术技术优势和耐久性的同时，将并发症降至最低。
