Bases anatomiques de l'abord antérieur rétropéritonéal minimisé de la colonne lombaire
| Autor: | H. Guérin-Surville, N. Mora, S. Ramare, R. Trabelsi, Gérard Saillant, J. Y. Lazennec, S. Hansen, B. Pouzet |
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| Rok vydání: | 1999 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty medicine.medical_treatment Anastomosis Prosthesis Pathology and Forensic Medicine Ureter Cadaver medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Lumbar Vertebrae business.industry Extraperitoneal approach Hypogastric Plexus Middle Aged Surgery Dissection Spinal Fusion medicine.anatomical_structure Spinal Injuries Orthopedic surgery Female Spinal Diseases Radiology Anatomy business |
| Zdroj: | Surgical and Radiologic Anatomy. 21:7-15 |
| ISSN: | 1279-8517 0930-1038 |
| Popis: | Anterior lumbar spine approaches may be indicated for fusion in degenerative lumbar spine disorders or to fill discal and bone gaps after fracture reduction. We present an anterior extraperitoneal approach applicable to any discal and vertebral levels from T12 to S1. The anatomic study, based on 25 cadavers, highlights retroperitoneal dissection principles for easy kidney and duodenopancreatic mobilisation and direct left anterior access to the entire lumbar spine. We established a precise description of the lumbar veins and the anastomoses between the left renal vein and hemiazygos system, in order to define different topographic and anatomic factors related to safe and easily reproducible approaches for cage or graft implementation. Independent of the level and previous intraperitoneal surgery, lumbar spine access with this approach safeguards the kidney, ureter, spleen, hypogastric plexus and duodenopancreatic system. Regarding operating time, blood-loss and possibilities for freshening and grafting, this technique seems an effective counterbalance to the difficulties and complex technology of endoscopic approaches. The clinical study includes our first 42 cases in traumatic and degenerative lesions. Avoiding the neurologic or hemorrhagic risk inherent in classical posterior lumbar interbody fusion (PLIF) techniques, it can be considered as a reasonable and valid alternative. This technique could be used in the near future for mini invasive discal prosthesis insertion. |
| Databáze: | OpenAIRE |
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