Advances in spinal fusion techniques have led to an increase in the need for safe access to the lumbar spine anteriorly. This study aims to examine the procedure-related complications of anterior lumbar interbody fusion (ALIF) or anterior lumbar disc replacement (ALDR) when performed jointly by a vascular-surgeon and a neurosurgeon in a single center. The doctors conducted a retrospective cohort analysis for all patients who underwent ALIF or ALDR between 2004 and 2010. They examined the operative notes to identify any procedure-specific complications. In-hospital postoperative complications were recorded.

The study collected data of a total of 121 patients including 68 females and 53 males. The mean age was 44 years (range of 25–76). Eighty patients had ALIF, while 24 patients underwent ALDR. The remaining 17 patients had combined procedures for the multilevel disease. In all patients, a transperitoneal approach was performed by a vascular surgeon. The main indication for performing surgery was degenerative lumbar disc disease. No visceral or ‘major vascular’ complications were reported in any patients. Only three patients had ‘minor vascular’ injuries. Hence the conclusion is the anterior lumbar approach is not generally favored by many neurosurgeons, despite its many advantages, due to the significant risk of vascular injuries as reported in the literature.

Ref: https://www.tandfonline.com/doi/full/10.3109/02688697.2012.680629