Anterior lumbar fusion techniques: ALIF, OLIF, DLIF, LLIF, IXLIF

Publication date: Available online 6 December 2019Source: Orthopaedics &Traumatology: Surgery &ResearchAuthor(s): Jérôme Allain, Thierry DufourAbstractAn anterior approach to the lumbar spine is increasingly used in performing fusion. Depending on the level to be treated, several approaches have been developed to deal with the anatomic obstacles encountered: pure anterior, oblique anterior or lateral, and trans- or pre-psoas. Conventional techniques incur risk of muscle lesion and severe bleeding, and have been replaced by minimally invasive approaches, often with video assistance after rapid closure of laparoscopic approaches with gas insufflation. There has, in parallel, been great progress in anterior spinal instrumentation systems. Non-existent when these techniques were first developed, they have become increasingly sophisticated, and now employ a variety of stand-alone or not cages and anterior screwed plate that can be associated together or to posterior fixation. Each approach and type of fixation has its specific technical requirements that need to be fully mastered so as to minimize risk, especially regarding vessels, and to enable the patient to enjoy the benefit of their very low morbidity. We shall therefore detail here each step of the pure anterior approach, which is most often used for L5S1, the oblique and lateral approaches, mainly used for L2L5, and also the preparation of the lumbar spine for anterior interbody fusion, with the respect...
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research

Related Links:

AbstractIn the era of neoadjuvant chemoradiotherapy/radiotherapy and total mesorectal excision, overall oncological outcomes after curative resection of rectal cancer are excellent, with local recurrence rates as low as 5 –10%. However, lateral nodal disease is a major cause of local recurrence after neoadjuvant chemoradiotherapy/radiotherapy and total mesorectal excision. Patients with lateral nodal disease have a local recurrence rate of up to 30%. The oncological benefits of lateral pelvic lymph node dissection (LPLND) in reducing local recurrence, particularly in the lateral compartment, have been demonstrated. A...
Source: Surgery Today - Category: Surgery Source Type: research
ConclusionsWe found adequate evidence supporting the use of surgery for the treatment of symptomatic isthmocele, as it was found to improve the bleeding symptoms in more than 80% of patients. Differently, we found a lack of evidence regarding the role of surgery with the purpose of improving fertility or reducing the risk of obstetric complications in women with asymptomatic isthmocele. The hysteroscopic correction of isthmocele may be the safest and most effective strategy in those patients with adequate residual myometrial thickness overlying the isthmocele. Laparoscopic and vaginal surgeries may be the preferred options...
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
ConclusionVE is a new useful tool for the preoperative collection of data on small polypoid lesions in the small bowel.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Condition:   Uterine Bleeding Interventions:   Procedure: Vaginal hysterectomy;   Procedure: Laparoscopic hysterectomy Sponsor:   Mansoura University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conclusion ARM-b is safe, feasible, and symptom-effective for treating refractory GERD, and it can be performed in the ambulatory setting. Further prospective studies are required to confirm these promising outcomes. [...] © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text
Source: Endoscopy International Open - Category: Gastroenterology Authors: Tags: Original article Source Type: research
Conclusion Our meta-analysis demonstrated that the technical and clinical success of EDGE procedure is better than BE-ERCP and comparable to that of LA-ERCP in RYGB patients. EDGE also has a similar safety profile as compared to LA-ERCP but has higher AE rate as compared to BE-ERCP. [...] © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text
Source: Endoscopy International Open - Category: Gastroenterology Authors: Tags: Original article Source Type: research
Authors: Borgna V, Vidal I, Castillo OA Abstract OBJECTIVE: To compare peri-operative and mid-term oncological outcomes between Open radical cystectomy (ORC) and Laparoscopic radical cystectomy (LRC). METHODS: A retrospective cohort was assembled, in which 182 patients had been subjected consecutively to Radical Cystectomy (RC) for treatment of muscle-invasive bladder cancer (MIBC) between 2000 and 2010 in a single center. Two cohorts were included: ORC (n=83) and LRC (n=99). All the RCs were performed by the same surgeon. Perioperatory complications were registered according to Clavien-Dindo classification. We...
Source: Archivos Espanoles de Urologia - Category: Urology & Nephrology Tags: Arch Esp Urol Source Type: research
Authors: Kakushima N, Yoshida M, Yabuuchi Y, Kawata N, Takizawa K, Kishida Y, Ito S, Imai K, Hotta K, Ishiwatari H, Matsubayashi H, Ono H Abstract Prediction of histology by endoscopic examination is important in the clinical management of non-ampullary duodenal epithelial tumors (NADETs), including adenoma and adenocarcinoma. The use of a simple scoring system based on the findings of white-light endoscopy or magnified endoscopy with narrow-band imaging is useful to differentiate between Vienna category 3 (C3) and C4/5 lesions. Less invasive endoscopic resection procedures, such as cold snare polypectomy, are quic...
Source: Clinical Endoscopy - Category: Gastroenterology Tags: Clin Endosc Source Type: research
Conclusion: LC can be safely performed in cirrhotic patients. However, higher CTP and MELD scores, operative bleeding, more blood and plasma transfusion units, longer operative time, lower platelet count, and higher INR values are predictors of poor outcome that can be improved by proper patient selection and meticulous peri-operative care and by using Harmonic scalpel shears.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
AbstractBackgroundWe used a population-based database to: (1) compare clinical and economic outcomes between minimally invasive surgery (MIS) and open surgery (OS) for colectomy; and (2) evaluate contemporary trends in MIS rates.MethodsRetrospective Premier Healthcare Database review of patients undergoing elective inpatient colectomy between January 1, 2010 and September 30, 2017 (first  = index admission). Patients were classified into MIS (laparoscopic/robotic) or OS groups, and by left or right colectomy. Propensity score matching (1:1 ratio) of MIS and OS groups was used to address potential confounding ...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
More News: Bleeding | Laparoscopy | Orthopaedics