During the last decade there has been a tremendous increase in the number procedures done by spine surgeons on the front of the spine. Traditionally, operations on the spine have been done predominately from behind, through the back. Newer devices, placed through the front of the spine, have increased in popularity for certain conditions. Vascular surgeons frequently perform the exposure to the front of the spine as these operations are typically in an area near major blood vessels.
The decision to perform an anterior spinal procedure is made by the spine surgeon. Most procedures are fusions, meant to reduce the pain associated with motion or deformity of the spine. The surgeons of Vascular Surgery Associates have been involved with two clinical research trials evaluating artificial disc technology to replace worn out lumbar discs and restore normal motion. Since 1996, the surgeons of Vascular Surgery Associates have performed the exposure for over 1,500 anterior spinal procedures of the thoracic and lumbar spine for a variety of conditions, including degenerative disc disease, scoliosis, infection and tumors.
In most cases a single level exposure is performed through a two to four inch incision. The size and location of the incision depends on the level(s) involved and the patient’s build. Typically, a muscle-sparing incision is used to divide the tissue between the rectus muscles. Behind the abdominal muscles is a sac that is left intact and moved aside, exposing the major blood vessels and the spine. After mobilizing the arteries and veins, the tissue is placed behind self-retaining retractors to provide a pathway to the spine for the spine surgeon.
Consultation with the vascular surgeon prior to the procedure is important to explain our role, discuss medical history that may influence the operation and allow an opportunity to explain the risks of the procedure.