Reply to the Letter to the Editor: The Oblique Anterolateral Approach to the Lumbar Spine Provides Access to the Lumbar Spine With Few Early Complications
Year: 2016
Type: letter
Abstract: To the Editor, We would like to thank the authors for their interest and critical review of our manuscript [2]. We would like to take this opportunity to address their comments and questions. The authors of the letter questioned whether there was a correlation between the risk of retroperitoneal hematoma infection and the operated level. We apologize for not including this information in our publication. Our data showed that with the numbers available there was no relevant correlation between the surgical level and the occurrence of the abovementioned postoperative complications. We observed a total of 11 hematomas overall. Four of those patients underwent surgery at two contiguous levels (L3-L5 in three patients and L2-L4 in one patient). The remaining seven patients were recorded as single-level procedures (four patients at L4/5; three patients at L3/4, respectively). Likewise, with the numbers available, we observed no relationship between the spinal level and the risk of developing infection; among patients who developed infection, there were two double-level procedures, both performed at L3-L5, and three single-level procedures at the L4/5 levels. The authors of the letter also asked about the rate of retroperitoneal hematomas, which some believe may be higher when utilizing the transmuscular approach. Unfortunately, we cannot answer this question as we did not compare the anterolateral oblique and the transpsoas approach directly in this study. To our knowledge, no published studies have appropriately investigated this research question by means of routine postoperative MRI images. However, as pointed out in the introduction of our manuscript, the risks associated with both postoperative hip flexor and quadriceps weakness, which have been linked to the transmuscular approach, can range between 20% and 36% [1, 3]. Finally, we would like to thank the authors for sharing their experiences with the oblique anterolateral approach to the lumbar spine and, in particular, pointing out the incidence of vascular complications.
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2556575550