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Complication avoidance and management in anterior lumbar interbody fusion.

Publication ,  Journal Article
Than, KD; Wang, AC; Rahman, SU; Wilson, TJ; Valdivia, JM; Park, P; La Marca, F
Published in: Neurosurg Focus
October 2011

The goal of this study was to review the literature to compare strategies for avoiding and treating complications from anterior lumbar interbody fusion (ALIF), and thus provide a comprehensive aid for spine surgeons. A thorough review of databases from the US National Library of Medicine and the National Institutes of Health was conducted. The complications of ALIF addressed in this paper include pseudarthrosis and subsidence, vascular injury, retrograde ejaculation, ileus, and lymphocele (chyloretroperitoneum). Strategies identified for improving fusion rates included the use of frozen rather than freeze-dried allograft, cage instrumentation, and bone morphogenetic protein. Lower cage heights appear to reduce the risk of subsidence. The most common vascular injury is venous laceration, which occurs less frequently when using nonthreaded interbody grafts such as iliac crest autograft or femoral ring allograft. Left iliac artery thrombosis is the most common arterial injury, and its occurrence can be minimized by intermittent release of retraction intraoperatively. The risk of retrograde ejaculation is significantly higher with laparoscopic approaches, and thus should be avoided in male patients. Despite precautionary measures, complications from ALIF may occur, but treatment options do exist. Bowel obstruction can be treated conservatively with neostigmine or with decompression. In cases of postoperative lymphocele, resolution can be attained by creating a peritoneal window. By recognizing ways to minimize complications, the spine surgeon can safely use ALIF procedures.

Duke Scholars

Published In

Neurosurg Focus

DOI

EISSN

1092-0684

Publication Date

October 2011

Volume

31

Issue

4

Start / End Page

E6

Location

United States

Related Subject Headings

  • Spinal Fusion
  • Randomized Controlled Trials as Topic
  • Postoperative Complications
  • Neurology & Neurosurgery
  • Lumbar Vertebrae
  • Humans
  • Disease Management
  • Databases, Factual
  • 3209 Neurosciences
  • 1109 Neurosciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Than, K. D., Wang, A. C., Rahman, S. U., Wilson, T. J., Valdivia, J. M., Park, P., & La Marca, F. (2011). Complication avoidance and management in anterior lumbar interbody fusion. Neurosurg Focus, 31(4), E6. https://doi.org/10.3171/2011.7.FOCUS11141
Than, Khoi D., Anthony C. Wang, Shayan U. Rahman, Thomas J. Wilson, Juan M. Valdivia, Paul Park, and Frank La Marca. “Complication avoidance and management in anterior lumbar interbody fusion.Neurosurg Focus 31, no. 4 (October 2011): E6. https://doi.org/10.3171/2011.7.FOCUS11141.
Than KD, Wang AC, Rahman SU, Wilson TJ, Valdivia JM, Park P, et al. Complication avoidance and management in anterior lumbar interbody fusion. Neurosurg Focus. 2011 Oct;31(4):E6.
Than, Khoi D., et al. “Complication avoidance and management in anterior lumbar interbody fusion.Neurosurg Focus, vol. 31, no. 4, Oct. 2011, p. E6. Pubmed, doi:10.3171/2011.7.FOCUS11141.
Than KD, Wang AC, Rahman SU, Wilson TJ, Valdivia JM, Park P, La Marca F. Complication avoidance and management in anterior lumbar interbody fusion. Neurosurg Focus. 2011 Oct;31(4):E6.

Published In

Neurosurg Focus

DOI

EISSN

1092-0684

Publication Date

October 2011

Volume

31

Issue

4

Start / End Page

E6

Location

United States

Related Subject Headings

  • Spinal Fusion
  • Randomized Controlled Trials as Topic
  • Postoperative Complications
  • Neurology & Neurosurgery
  • Lumbar Vertebrae
  • Humans
  • Disease Management
  • Databases, Factual
  • 3209 Neurosciences
  • 1109 Neurosciences