The Anterior Approach to Spine Surgery

The Anterior Approach to Spine Surgery is a method of operating on the spine from the front. Since the 1950s, the anterior approach to the spine has been used. The procedure used to entail a wide abdominal incision through which the surgeon would cut into the abdominal muscles and peritoneal cavity in order to obtain access to the spine. The intestines of the patient are housed in the peritoneal cavity. Due to the extensive dissection of the abdomen and muscles required to gain access to the spine, this would necessitate a lengthy healing period. Lets know more about Anterior Approach to Spine Surgery.

Lumbar Spine Fusion

The anterior approach to lumbar spine fusion (or other spine surgery, such as the artificial disc) can now be done with a minimally invasive method, which involves the stages below: Let’s know more about Anterior Approach to Spine Surgery.

1. For a single level fusion operation, a minor incision (about 3-5 inches) is created. This incision is commonly 4 to 5 inches below the belly button and may usually be hidden by the patient’s clothes, especially if a lower lumbar disc level (such as L5-S1) is being fused.
2. A retroperitoneal (behind the peritoneum—the membrane that lines the abdomen) muscle sparing approach is usually used, which means the front abdominal muscles are gently shifted to the side rather than being cut, and the peritoneal cavity is not accessed.
3. The peritoneal cavity is shifted to the side to provide access to the midline spinal column. The abdomen is a “bag within a bag,” with the inner bag containing the intestines not being accessed. Let’s know more about Anterior Approach to Spine Surgery.

Large blood arteries run directly in front of the vertebral bodies of the spine, carrying blood back and forth to the legs. Some of these vessels may need to be gently retracted to provide access to the disc space, depending on the level of the disc. A vascular surgeon or general surgeon is required to assist with the anterior approaches to help achieve exposure to the disc because to the dangers and unique expertise involved with manipulating blood vessels.

The deteriorated disc is removed once the disc space has been exposed, and disc material that is bulging on the nerve roots can be carefully removed. At this time, the disc space can be restored to its original height, which will relieve pressure on the nerve roots in the foramen space and assist the spine regain its lordosis. The empty disc area would subsequently be filled with a structural bone transplant, cage, total disc replacement, or other device. Let’s know more about Anterior Approach to Spine Surgery.

The anterior approach to spine fusion, like all surgical procedures, includes a few risks and potential consequences that are unique to this surgical strategy.

       • Damage to blood vessels. Injury to the big blood vessels is uncommon, occurring in about 1-2 percent of the time. To enable the spine surgeon get access to the front of the spine, a vascular surgeon (or a general surgeon with the proper skills and training) should be included in the surgery to manage the big blood arteries.

• Ejaculation in reverse. Retrograde ejaculation is an uncommon (1% ) consequence of the anterior approach to spine surgery in male patients. A group of tiny nerves can sit across the lowest disc space at the lower end of the lumbar spine (L5-S1). After ejaculation, these neurons help control a valve that is required to express semen, and the semen instead moves up into the bladder. Let’s know more about Anterior Approach to Spine Surgery.

      • The nerves have no influence on erectile function, which is controlled by a separate set of nerves. The majority of patients who develop this issue recover on their own within 3 to 6 months, however if fertility assistance is required, a urologist can be consulted. If the retrograde ejaculation becomes permanent, the patient may be unable to conceive children (without the help of a fertility specialist), but sexual function will be normal. Let’s know more about Anterior Approach to Spine Surgery.

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Other risks and potential complications linked with anterior spine surgery, such as infection, are similar to those associated with posterior spinal surgery and are not specific to the anterior method. Infection is extremely uncommon. The blood supply in the area is great.

Non-unions are possible, but if done correctly, patients should have a fusion rate of 90-95 percent. The effectiveness of pain management in people with degenerative disc disease varies, however it has been shown to be beneficial in 60 percent to 90 percent of cases.

Dr Vipin the managing director of KLM Group. He is a well-known  gold-medalist Orthopedic Surgeon, strongly reputed for his trusted and focused attitude our rich knowledge and experience, be assured of quality healthcare and world-class medical services in Orthopaedic, Spine care, Ophthalmology, X-ray & Diagnostics services along with physiotherapy services.   

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