Department of neurosurgery, Dijon University Hospital, 15, rue Paul-Gaffarel, 21000 Dijon, France.
Department of neurosurgery, Dijon University Hospital, 15, rue Paul-Gaffarel, 21000 Dijon, France; Hôpital Privé Dijon Bourgogne, Dijon, France.
Neurochirurgie. 2020 Dec;66(6):466-470. doi: 10.1016/j.neuchi.2020.08.010. Epub 2020 Oct 27.
Anterior Lumbar Interbody Fusion is now a well-established procedure to treat degenerative lumbar disease. This approach has its own risks and each spine surgeon must understand the pitfalls that can be encountered when dealing with an anatomy variation of the vessels in order to be able to perform the safest possible procedure.
We report the case of a 48 years old man with a rare vascular anatomy variation undergoing a two-levels L4-L5 and L5-S1 ALIF procedure through a right-sided retroperitoneal approach. The preoperative imaging planning revealed a duplication of the Inferior Vena Cava (IVC) located on each side of the aorta.
Preoperative Imaging evaluation and a detailed knowledge of the anatomy is the key of a safe and successful procedure as any variation can complicate the anterior approach. We believe that teaming up with a vascular surgeon for junior surgeons during the first anterior procedures and especially in the context of anatomical variation is recommended.
前路腰椎间融合术（ALIF）现已成为治疗退行性腰椎疾病的成熟手术。该方法有其自身的风险，每位脊柱外科医生都必须了解在处理血管解剖变异时可能遇到的陷阱，以便能够进行尽可能安全的手术。
我们报告了一例 48 岁男性的罕见血管解剖变异病例，该患者接受了两节段 L4-L5 和 L5-S1 的 ALIF 手术，采用右侧腹膜后入路。术前影像学规划显示下腔静脉（IVC）在主动脉两侧各有一处重复。
术前影像学评估和对解剖结构的详细了解是安全、成功手术的关键，因为任何变异都可能使前路手术复杂化。我们认为，对于初级外科医生来说，在进行首次前路手术时，特别是在存在解剖变异的情况下，与血管外科医生合作是值得推荐的。
