Need of vascular surgeon and comparison of value for anterior lumbar interbody fusion (ALIF) in lateral decubitus: Delphi consensus.

ALIF Anterior spinal approach Degenerative disc disease Interbody spine fusion Spine surgery

Journal

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
ISSN: 1432-0932
Titre abrégé: Eur Spine J
Pays: Germany
ID NLM: 9301980

Informations de publication

Date de publication:
09 2022
Historique:
received: 15 11 2021
accepted: 06 07 2022
revised: 03 07 2022
pubmed: 23 7 2022
medline: 3 9 2022
entrez: 22 7 2022
Statut: ppublish

Résumé

Anterior lumbar approaches are recommended for clinical conditions that require interbody stability, spinal deformity corrections or a large fusion area. Anterior lumbar interbody fusion in lateral decubitus position (LatALIF) has gained progressive interest in the last years. The study aims to describe the current habit, the perception of safety and the perceptions of need of vascular surgeons according to experienced spine surgeons by comparing LatALIF to the standard L5-S1 supine ALIF (SupALIF). A two-round Delphi method study was conducted to assess the consensus, within expert spine surgeons, regarding the perception of safety, the preoperative planning, the complications management and the need for vascular surgeons by performing anterior approaches (SupALIF vs LatALIF). A total of 14 experts voluntary were involved in the survey. From 82 sentences voted in the first round, a consensus was reached for 38 items. This included the feasibility of safe LatALIF without systematic involvement of vascular surgeon for routine cases (while for revision cases the involvement of the vascular surgeon is an appropriate option) and the appropriateness of standard MRI to evaluate the accessibility of the vascular window. Thirteen sentences reached the final consensus in the second round, whereas no consensus was reached for the remaining 20 statements. The Delphi study collected the consensus on several points, such as the consolidated required experience on anterior approaches, the accurate study of vascular anatomy with MRI, the management of complications and the significant reduction of the surgical times of the LatALIF if compared to SupALIF in combined procedures. Furthermore, the study group agrees that LatALIF can be performed without the need for a vascular surgeon in routine cases.

Sections du résumé

BACKGROUND AND PURPOSE
Anterior lumbar approaches are recommended for clinical conditions that require interbody stability, spinal deformity corrections or a large fusion area. Anterior lumbar interbody fusion in lateral decubitus position (LatALIF) has gained progressive interest in the last years. The study aims to describe the current habit, the perception of safety and the perceptions of need of vascular surgeons according to experienced spine surgeons by comparing LatALIF to the standard L5-S1 supine ALIF (SupALIF).
METHODS
A two-round Delphi method study was conducted to assess the consensus, within expert spine surgeons, regarding the perception of safety, the preoperative planning, the complications management and the need for vascular surgeons by performing anterior approaches (SupALIF vs LatALIF).
RESULTS
A total of 14 experts voluntary were involved in the survey. From 82 sentences voted in the first round, a consensus was reached for 38 items. This included the feasibility of safe LatALIF without systematic involvement of vascular surgeon for routine cases (while for revision cases the involvement of the vascular surgeon is an appropriate option) and the appropriateness of standard MRI to evaluate the accessibility of the vascular window. Thirteen sentences reached the final consensus in the second round, whereas no consensus was reached for the remaining 20 statements.
CONCLUSIONS
The Delphi study collected the consensus on several points, such as the consolidated required experience on anterior approaches, the accurate study of vascular anatomy with MRI, the management of complications and the significant reduction of the surgical times of the LatALIF if compared to SupALIF in combined procedures. Furthermore, the study group agrees that LatALIF can be performed without the need for a vascular surgeon in routine cases.

Identifiants

pubmed: 35867159
doi: 10.1007/s00586-022-07319-3
pii: 10.1007/s00586-022-07319-3
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2270-2278

Informations de copyright

© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Références

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Auteurs

Cristiano Magalhães Menezes (CM)

Biocor/ Vila da Serra Hospital, Columna Institute, Belo Horizonte, Brazil.

Todd Alamin (T)

Department of Orthopedic Surgery and Neurosurgery, Stanford University Medical Center, Redwood City, CA, USA.

Rodrigo Amaral (R)

Instituto de Patologia da Coluna (IPC), São Paulo, Brazil.

Alexandry Dias Carvalho (AD)

Hospital Universitário Do Piauí, Teresina, Brazil.

Roberto Diaz (R)

Pontificia Universidad Javeriana Hospital Universitario San Ignacio, Bogotá, D.C, Colombia.

Alfredo Guiroy (A)

Elite Spine Health and Wellness Center, Fort Lauderdale, Florida, USA.

Khai S Lam (KS)

The London Bridge Hospital, London, UK.

Claudio Lamartina (C)

IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.

Alberto Perez-Contreras (A)

Director de Líderes en Cerebroy, Columna del Hospital Angeles del Pedregal, Ciudad de Mexico, Mexico.

Yamil Rivera-Colon (Y)

Puerto Rico Spine Center, San Juan, Puerto Rico.

Willian Smith (W)

University Medical Center of Southern Nevada, Las Vegas, NV, USA.

Nestor Taboada (N)

Department of Neurosurgery, Clínica Portoazul, Barranquila, Colombia.

Jake Timothy (J)

Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Francesco Langella (F)

IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. francesco.langella.md@gmail.com.

Pedro Berjano (P)

IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.

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