Lumbar spine surgery by abdominal route

Surgical interventions present a wide range of indications and needs to correct the acute or chronic problem. With regard to surgical treatment of the spine, thanks to advances in biomedical sciences, engineering, as well as improvements in protocols and quality in imaging tests, it is possible to make all the predictions on the material that is It will require the approximate surgery time as well as improving the choice of a less aggressive approach, treating the pathology completely, allowing us to reach an effectiveness that a few decades ago was hardly imaginable.

It is a selective intervention performed anteriorly to treat severe discopathy that affects the biomechanics of the lumbar spine. They require a correct etiological diagnosis and assess the segment to be treated as well as discard secondary diagnoses and assess the existence or not of neurological complications and instabilities that require fixation on their part.

This intervention is indicated mostly in moderate or severe disc disease at the lumbar level. And they do not present an indication for subsequent surgical treatment such as joint hypertrophy or foraminal stenosis due to posterior osteophytes. Although discopathies can last a long time and continue to give constant symptoms with recurrent crises, chronic lesions with osteoarthritis or posterior joint deformation can produce both central stenosis and foraminal stenosis, giving very specific symptoms depending on the level of compression and which is justified by a failure in conservative treatment or constant and evolving neurological involvement. A particular indication for the anterior route usually occurs in discopathies, especially at the L5-S1 or L4-L5 level, assessing assertively whether it will be possible to avoid vascular lesions during the procedure. An experienced surgeon understands these concepts very well and before proposing this treatment, he will have made a precise diagnosis and explained the therapeutic alternatives in his case.

It is performed in the operating room under general anesthesia, for which a preoperative study with the anesthetist is necessary and can be performed a few days before. During the procedure, a fluoroscope is also used to locate the region to be intervened, marking before the incision and controlling the procedure with it to avoid commenting on errors and treating segments that are not affected. The procedure usually lasts between 60 minutes on average and consists of the removal of the disc that causes problems with the placement of a prosthesis that will allow adequate movement of the segment once it is consolidated in the vertebral body or of a fixed disc that will prevent the segment from move incorrectly and damage the nerves that leave the spine as well as preventing the progress and development of osteoarthritis at the level of the posterior joints.