| Case report: incisional hernia as a complication of extreme lateral interbody fusion. | |
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MedLine Citation:
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PMID: 22480529 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND CONTEXT: Minimal access surgery is becoming more popular for spinal fusion because of a lower theoretical risk of complications and shorter postoperative recovery period, compared with the traditional open approach. The lateral approach uses retroperitoneal transpsoas access to the vertebra, obviating the need for an approach surgeon and minimizing muscular disruption, thus allowing a quicker recovery. Initial reports of the lateral transpsoas procedure described few complications. However, a number of complications have subsequently been documented. To our knowledge, there has not been a description of an incisional hernia after this approach. PURPOSE: To report the rare complication of an incisional hernia after a minimal access lateral transpsoas approach for lumbar interbody fusion. STUDY DESIGN: Case report. METHODS: We reviewed the hospital charts, radiographs, and intraoperative photographs of a patient who underwent a minimally invasive lateral approach lumbar spine fusion with a subsequent incisional hernia that necessitated laparoscopic repair. RESULTS: A 75-year-old woman with a history of low back and left lower extremity pain with radiographic evidence of foraminal stenosis and degenerative spondylolisthesis underwent a successful L4-L5 discectomy with an extreme lateral interbody fusion via a retroperitoneal transpsoas approach. This was supplemented with a posterior minimally invasive surgery instrumented fusion from L4 to L5. The patient reported significant improvement in symptoms on initial follow-up, however, complained of a prominence over her incision 4 weeks later. An incisional hernia was diagnosed and subsequently repaired laparoscopically, from which the patient recovered uneventfully. CONCLUSIONS: Postoperative incisional hernia after extreme lateral interbody fusion is a complication that has not been previously described in the literature but is one that spine surgeons must recognize. This case may prompt surgeons to use a more posterior approach to avoid this complication. Additionally, direct repair of the transversalis fascia is critical to avoiding this complication. |
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Authors:
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Timothy V Galan; Vivek Mohan; Eric O Klineberg; Munish C Gupta; Rolando F Roberto; Joshua P Ellwitz |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-4-3 |
Journal Detail:
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Title: The spine journal : official journal of the North American Spine Society Volume: - ISSN: 1878-1632 ISO Abbreviation: - Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-4-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101130732 Medline TA: Spine J Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Elsevier Inc. All rights reserved. |
Affiliation:
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University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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