MIXED BAG Anterior paramedian retroperitoneal Anterior - PowerPoint PPT Presentation

MIXED BAG Anterior paramedian • retroperitoneal Anterior transperitoneal • Flank Incision • Retroperitoneal Lateral trans psoas • (XLIF) Posterior •

The Surgical and Medical Perioperative Complications of Anterior Spinal Fusion Surgery in the Thoracic and Lumbar Spine in Adults: A Review of 1223 Procedures Faciszewski, Tom MD; Winter, Robert B. MD; Lonstein, John E. MD; Denis, Francis MD; Johnson, Linda PhD Spine: July 15th, 1995 European Spine Journal March 2013, Volume 22, Supplement 1, pp 16–20| Cite as Access related complications in anterior lumbar surgery performed by spinal surgeons Authors Authors and affiliations Nasir A. QuraishiEmail authorM. KonigS. J. BookerM. ShafafyB. M. BoszczykM. P. GrevittH. MehdianJ. K. Webb Global Spine J 2016; 06(02): 147-154 DOI: 10.1055/s-0035-1557141 Georg Thieme Verlag KG Stuttgart · New York Approach-Related Complications of Anterior Lumbar Interbody Fusion: Results of a Combined Spine and Vascular Surgical Team Ralph J. Mobbs1, 2, 3, Kevin Phan1, 2, Daniel Daly3, Prashanth J. Rao1, 2, 3, Andrew Lennox1, 3, 4 The Unique Complications of Coccidioidomycosis of the Spine: A Detailed Time Line of Disease Progression and Suppression Lewicky, Yuri M. MD; Roberto, Rolando F. MD; Curtin, Stephen L. MD Spine: October 1st, 2004 - Volume 29 - Issue 19 - p E435-E441 doi: 10.1097/01.brs.0000141175.18790.fe Case Report European Spine Journal April 2015, Volume 24, Supplement 3, pp 287–313 | Cite as MIS lateral spine surgery: a systematic literature review of complications, outcomes, and economics Authors Authors and affiliations Jeff A. LehmenEmail authorEdward J. Gerber

Abdominal complications from Anterior spine Surgery Vascular: 6.2-13.8% Viscus: 1.6-3.9% Genitourinary: 0-7.2% Abdominal wall: 1.3% Neurological: 13-75% XLIF 0-5% old school Infection: 2.2-4.3%

The Unique Complications of Coccidiodomycosis of the Spine: A Detailed Time Line of Disease Progression and Suppression Lewicky, Yuri M. MD; Roberto, Rolando F. MD; Curtin, Stephen L. MD Spine: October 1st, 2004 - Volume 29 - Issue 19 - p E435-E441 Case Report

36 yo black female with • chronic L5-S1 Cocci osteodiscitis with recurrent presacral abscess Previous staged anterior • debridement and posterior stabilization 2 years prior and subsequent hardware removal 6 months prior Re-exploration and • debridement and placement of CaSO4 pellets with General/vascular surgeon

Postop ileus, mild • distension, no pain, no change in vitals POD#3 has BM with • CaSO4 pellets seen in the toilet Perforated sigmoid • colon Diverting colostomy • performed

Over the course of the • next year patient had another posterior debridement and a case of pericarditis 14 months post-op she • had colostomy take down Two year post-op no • pain, doing well, continues on Fluconazole 800mg/day

Personal recommendations Anterior approaches with • access/co-surgeon Working relationship with • access/co-surgeon Recognize hidden bleeding • Consider all possibilities • Re-exploration vs advanced • imaging/interventional radiology Working relationship with • access/co-surgeon and interventional radiologist