Bassani R, Querenghi A M, Cecchinato R, Morselli C, Casero G, Gavino D, Brock S, Ferlinghetti C
Spine Surgery 2, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
GSpine 4, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Eur Spine J. 2018 Aug;27(8):1956-1963. doi: 10.1007/s00586-018-5659-0. Epub 2018 Jun 9.
The purpose of this study is to evaluate the feasibility and the safety of a new skin incision for minimally invasive anterior lumbar interbody fusion (ALIF): the perinavel incision.
Demographic and clinical data from patients who underwent ALIF with the perinavel incision were collected. Indications to surgery, preoperative symptoms, radiological data, number of treated levels, intraoperative and early postoperative complications and wound-related problems were analysed.
Ninety-seven patients underwent ALIF with this new skin incision. One hundred fifty-seven levels were treated (mean 1.7 level per patient) being L4-L5 the most frequently treated. Intraoperative complications were represented only by the venous injury with a rate of 3.09% (3 cases). Postoperative complications were all linked to skin incision issues: a case of wound dehiscence and a case of superficial infection. No case of skin necrosis occurs at 3-month follow-up.
In this paper, the perinavel skin incision was demonstrated to be as safe as traditional approaches for ALIF. Furthermore, with this incision it is possible to perform multilevel (L3-S1) ALIF, which means a good option in minimally invasive surgery as well as revision surgery. These slides can be retrieved under Electronic Supplementary Material.
本研究旨在评估一种用于微创前路腰椎椎间融合术（ALIF）的新皮肤切口——脐周切口的可行性和安全性。
收集接受脐周切口ALIF手术患者的人口统计学和临床数据。分析手术指征、术前症状、影像学数据、治疗节段数、术中和术后早期并发症以及与伤口相关的问题。
97例患者接受了这种新皮肤切口的ALIF手术。共治疗157个节段（平均每位患者1.7个节段），其中L4-L5节段治疗最为频繁。术中并发症仅为静脉损伤，发生率为3.09%（3例）。术后并发症均与皮肤切口问题有关：1例伤口裂开和1例浅表感染。在3个月的随访中未出现皮肤坏死病例。
本文表明，脐周皮肤切口对于ALIF手术而言与传统手术方法一样安全。此外，采用该切口可以进行多节段（L3-S1）ALIF手术，这意味着在微创手术以及翻修手术中是一个不错的选择。这些幻灯片可在电子补充材料中获取。
