Exposure Issues in Lumbar Disc Replacement Surgery

Total lumbar disc replacement must be performed through an anterior approach to the spine. As there are numerous other sources that describe techniques of anterior lumbar exposures, this article focuses on the incidence of significant complications that are to be expected in these operations. Some recommendations are made as to how to possibly avoid or reduce these complications. Preoperative evaluation is important in determining which patients present a greater risk. Intraoperative techniques will be described that help reduce the incidence of these complications. Methods of making an early diagnosis will also be discussed, as well as tactics for managing intraoperative complications. Finally, recommendations are made for reducing and managing problems encountered during revision surgery.

Keywords:  lumbar arthroplasty , vascular injury , retrograde ejaculation , ureteral injury , revision strategies