Vascular injury in elective anterior lumbosacral surgery.

摘要: STUDY DESIGN Systematic review. OBJECTIVE To document the incidence and consequences of vascular injury in lumbosacral surgery, to identify factors contributing this injury, determine whether there are any effective measures decrease occurrence injury. SUMMARY OF BACKGROUND DATA Anterior surgery encompasses all aspects spine including trauma, deformity, degenerative conditions. Although it has theoretical advantages, anterior carries with certain definite risks, one most critical which is surrounding vasculature. It important for both patient surgeon understand patterns, outcomes structures associated surgery. METHODS A systematic review English-language literature was undertaken articles published between January 1993 December 2008. Electronic databases reference lists key were searched studies examining Vascular defined as case a suture required control bleeding. Two independent reviewers assessed strength using Grading Recommendations Assessment, Development, Evaluation criteria assessing quality, quantity, consistency results. Disagreements resolved by consensus. RESULTS total 88 initially screened, 40 ultimately met predetermined inclusion criteria. injuries after surgeries rare (<5%). Venous laceration more common than arterial laceration, venous occurred during retraction great vessels. In cases, overall clinical outcome not adversely affected. L4-L5 exposure increased some but others. frequently laparoscopic compared open lumbar interbody fusion. CONCLUSION remains low, reports being <5%. The seem rare, may include thrombosis, pulmonary embolism, prolonged hospitalization. Exposure at be higher risk that L5-S1, though data consistent.