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KMID : 1134220080280010070
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Hanyang Medical Reviews
2008 Volume.28 No. 1 p.70 ~ p.76
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Minimally invasive anterior approach to the lumbar spine
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Bak Koang-Hum
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Abstract
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A technique and clinical experiences of minimally invasive anterior lumbar interbody fusion ( mini-ALIF ) are reported. Despite its biomechanical advantages and high fusion rate, conventional ALIF needs a long skin incision and extensive
dissection. Endoscopic approaches for ALIF seem to be associated with considerable technical difficulties, long operation time, and high complication rate even in collaboration with a laparoscopic surgeon.
Mini-ALIF involves a standardized minimally invasive microsurgical retroperitoneal approach for L2-3 to L4-5, and transperitoneal approach for L5-S1. Mini-ALIF can be done through minimal skin incision(4-5cm) and blunt muscle dissection without abdominal muscle cutting.
The surgical indications are degenerative disc diseases, disc herniations, degenerative spondylolisthesis, and iatrogenic postoperative instability including postoperative pseudarthrosis. Lumbar artificial disc replacement is a new indication
to this technoque.
Mini-ALIF provided sufficient operation space for lumbar interbody fusion. Consequently, operation time, bleeding, and postoperative morbidity of ALIF could be reduced.
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KEYWORD
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Minimally invasive spine surgery, Anterior umbar interbody fusion, Spinal fusion, Lumbar spine, Microsurgery
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