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Anterior Lumbar Surgery: Just How Safe Is It?
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Posted on: 10/11/2004
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Things are changing in the world of spine surgery. Artificial discs and new bone graft substitute are making repair of the degenerative spine possible. Doctors are entering the spine from the front of the body in an operation called anterior lumbar surgery (ALS). This approach avoids damaging the spinal cord. However, it does put the blood vessels at risk.
For this reason, special doctors called vascular surgeons are part of the surgical team for ALS. Vascular surgeons make sure the blood vessels are moved out of the way and left uninjured after the operation. But just how often do injuries to the blood vessels occur? That's the focus of this study.
One doctor followed 1,310 patients after doing an ALS on each one. Only 25 patients had any problems with blood clots or accidental cutting of a blood vessel. That's less than a two percent rate of complications. Risk factors for complications include gender (women have a greater risk) and spinal level (more problems occur at the L4/L5 level).
The authors sum up their findings by giving doctors the following advice:
Don't release blood vessel retractors unless they've been in place more than one hour. Monitor oxygen levels in the left leg, the side where the artery gets the most pressure. Treat any problems that occur right away (if possible, while still in the operating room). Vascular and spine surgeons must work together to decide what to do. Remember that even the most routine operation can have problems.
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References:
Salvador A. Brau, MD, FACS, et al. Vascular Injury During Anterior Lumbar Surgery. In The Spine Journal. July/August 2004. Vol. 4. No. 4. Pp. 409-412.
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