Vascular injuries during anterior exposure of the thoracolumbar Spine

Vladimir Zahradnik, Daniel Lubelski, Kalil G. Abdullah, Rebecca Kelso, Thomas Mroz, Vikram S. Kashyap

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: The aim of this study was to evaluate the vascular injuries, repairs, and complications encountered during anterior thoracolumbar spine exposures. Methods: The medical records of patients undergoing anterior spine exposures from January 2004 to June 2010 were retrospectively analyzed. Results: A total of 269 anterior exposures were performed in 260 patients. The average patient age was 50.1 years, and the average body mass index was 29.0. Female patients represented 146 (54.3%) cases. Previous spinal surgery was noted in 145 (53.9%) cases, and 19 (7.1%) had previous anterior exposure. The median estimated blood loss (EBL) was 300 mL, and there were no postoperative mortalities. A vascular injury occurred in 37 cases (13.8%), with redo anterior exposure (n = 19, 52% vs. 11%; P < 0.001), previous spinal surgery (n = 145, 19% vs. 7%; P = 0.01), and diagnosis of a tumor (n = 14, 36% vs. 12.5%; P = 0.03) being associated with increased vascular injury. A vascular injury resulted in greater EBL (median: 800 mL vs. 300 mL; P < 0.001) and longer hospitalization (median: 7 days vs. 5 days; P = 0.04). Most frequently injured was the left common iliac vein (in 21 of the 37 [52.5%] injured cases). A vascular surgeon performed the exposure in 159 (59.1%) cases. There was a decrease in EBL (250 mL vs. 500 mL; P < 0.001), total incision time (290 minutes vs. 404 minutes; P = 0.002), and length of stay (5 days vs. 6.5 days; P < 0.001) as compared with the operations where the vascular surgeon was not involved in the exposure. These cases also had an increased incidence of any vascular injury (28 vs. 9; P = 0.04). There were no differences between groups regarding vascular injury type, repair type, or the incidence of deep venous thrombosis. Conclusion: Collaboration between spine and vascular teams may result in decreased blood loss and consequently improved morbidity and length of hospital stay.

Original languageEnglish (US)
Pages (from-to)306-313
Number of pages8
JournalAnnals of Vascular Surgery
Volume27
Issue number3
DOIs
StatePublished - Apr 1 2013
Externally publishedYes

Fingerprint

Vascular System Injuries
Spine
Blood Vessels
Length of Stay
Iliac Vein
Incidence
Venous Thrombosis
Medical Records
Hospitalization
Body Mass Index
Morbidity
Mortality
Neoplasms

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Vascular injuries during anterior exposure of the thoracolumbar Spine. / Zahradnik, Vladimir; Lubelski, Daniel; Abdullah, Kalil G.; Kelso, Rebecca; Mroz, Thomas; Kashyap, Vikram S.

In: Annals of Vascular Surgery, Vol. 27, No. 3, 01.04.2013, p. 306-313.

Research output: Contribution to journalArticle

Zahradnik, Vladimir ; Lubelski, Daniel ; Abdullah, Kalil G. ; Kelso, Rebecca ; Mroz, Thomas ; Kashyap, Vikram S. / Vascular injuries during anterior exposure of the thoracolumbar Spine. In: Annals of Vascular Surgery. 2013 ; Vol. 27, No. 3. pp. 306-313.
@article{c8b1374ecb3c4be3b8b3cd5a22339033,
title = "Vascular injuries during anterior exposure of the thoracolumbar Spine",
abstract = "Background: The aim of this study was to evaluate the vascular injuries, repairs, and complications encountered during anterior thoracolumbar spine exposures. Methods: The medical records of patients undergoing anterior spine exposures from January 2004 to June 2010 were retrospectively analyzed. Results: A total of 269 anterior exposures were performed in 260 patients. The average patient age was 50.1 years, and the average body mass index was 29.0. Female patients represented 146 (54.3{\%}) cases. Previous spinal surgery was noted in 145 (53.9{\%}) cases, and 19 (7.1{\%}) had previous anterior exposure. The median estimated blood loss (EBL) was 300 mL, and there were no postoperative mortalities. A vascular injury occurred in 37 cases (13.8{\%}), with redo anterior exposure (n = 19, 52{\%} vs. 11{\%}; P < 0.001), previous spinal surgery (n = 145, 19{\%} vs. 7{\%}; P = 0.01), and diagnosis of a tumor (n = 14, 36{\%} vs. 12.5{\%}; P = 0.03) being associated with increased vascular injury. A vascular injury resulted in greater EBL (median: 800 mL vs. 300 mL; P < 0.001) and longer hospitalization (median: 7 days vs. 5 days; P = 0.04). Most frequently injured was the left common iliac vein (in 21 of the 37 [52.5{\%}] injured cases). A vascular surgeon performed the exposure in 159 (59.1{\%}) cases. There was a decrease in EBL (250 mL vs. 500 mL; P < 0.001), total incision time (290 minutes vs. 404 minutes; P = 0.002), and length of stay (5 days vs. 6.5 days; P < 0.001) as compared with the operations where the vascular surgeon was not involved in the exposure. These cases also had an increased incidence of any vascular injury (28 vs. 9; P = 0.04). There were no differences between groups regarding vascular injury type, repair type, or the incidence of deep venous thrombosis. Conclusion: Collaboration between spine and vascular teams may result in decreased blood loss and consequently improved morbidity and length of hospital stay.",
author = "Vladimir Zahradnik and Daniel Lubelski and Abdullah, {Kalil G.} and Rebecca Kelso and Thomas Mroz and Kashyap, {Vikram S.}",
year = "2013",
month = "4",
day = "1",
doi = "10.1016/j.avsg.2012.04.023",
language = "English (US)",
volume = "27",
pages = "306--313",
journal = "Annals of Vascular Surgery",
issn = "0890-5096",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Vascular injuries during anterior exposure of the thoracolumbar Spine

AU - Zahradnik, Vladimir

AU - Lubelski, Daniel

AU - Abdullah, Kalil G.

AU - Kelso, Rebecca

AU - Mroz, Thomas

AU - Kashyap, Vikram S.

PY - 2013/4/1

Y1 - 2013/4/1

N2 - Background: The aim of this study was to evaluate the vascular injuries, repairs, and complications encountered during anterior thoracolumbar spine exposures. Methods: The medical records of patients undergoing anterior spine exposures from January 2004 to June 2010 were retrospectively analyzed. Results: A total of 269 anterior exposures were performed in 260 patients. The average patient age was 50.1 years, and the average body mass index was 29.0. Female patients represented 146 (54.3%) cases. Previous spinal surgery was noted in 145 (53.9%) cases, and 19 (7.1%) had previous anterior exposure. The median estimated blood loss (EBL) was 300 mL, and there were no postoperative mortalities. A vascular injury occurred in 37 cases (13.8%), with redo anterior exposure (n = 19, 52% vs. 11%; P < 0.001), previous spinal surgery (n = 145, 19% vs. 7%; P = 0.01), and diagnosis of a tumor (n = 14, 36% vs. 12.5%; P = 0.03) being associated with increased vascular injury. A vascular injury resulted in greater EBL (median: 800 mL vs. 300 mL; P < 0.001) and longer hospitalization (median: 7 days vs. 5 days; P = 0.04). Most frequently injured was the left common iliac vein (in 21 of the 37 [52.5%] injured cases). A vascular surgeon performed the exposure in 159 (59.1%) cases. There was a decrease in EBL (250 mL vs. 500 mL; P < 0.001), total incision time (290 minutes vs. 404 minutes; P = 0.002), and length of stay (5 days vs. 6.5 days; P < 0.001) as compared with the operations where the vascular surgeon was not involved in the exposure. These cases also had an increased incidence of any vascular injury (28 vs. 9; P = 0.04). There were no differences between groups regarding vascular injury type, repair type, or the incidence of deep venous thrombosis. Conclusion: Collaboration between spine and vascular teams may result in decreased blood loss and consequently improved morbidity and length of hospital stay.

AB - Background: The aim of this study was to evaluate the vascular injuries, repairs, and complications encountered during anterior thoracolumbar spine exposures. Methods: The medical records of patients undergoing anterior spine exposures from January 2004 to June 2010 were retrospectively analyzed. Results: A total of 269 anterior exposures were performed in 260 patients. The average patient age was 50.1 years, and the average body mass index was 29.0. Female patients represented 146 (54.3%) cases. Previous spinal surgery was noted in 145 (53.9%) cases, and 19 (7.1%) had previous anterior exposure. The median estimated blood loss (EBL) was 300 mL, and there were no postoperative mortalities. A vascular injury occurred in 37 cases (13.8%), with redo anterior exposure (n = 19, 52% vs. 11%; P < 0.001), previous spinal surgery (n = 145, 19% vs. 7%; P = 0.01), and diagnosis of a tumor (n = 14, 36% vs. 12.5%; P = 0.03) being associated with increased vascular injury. A vascular injury resulted in greater EBL (median: 800 mL vs. 300 mL; P < 0.001) and longer hospitalization (median: 7 days vs. 5 days; P = 0.04). Most frequently injured was the left common iliac vein (in 21 of the 37 [52.5%] injured cases). A vascular surgeon performed the exposure in 159 (59.1%) cases. There was a decrease in EBL (250 mL vs. 500 mL; P < 0.001), total incision time (290 minutes vs. 404 minutes; P = 0.002), and length of stay (5 days vs. 6.5 days; P < 0.001) as compared with the operations where the vascular surgeon was not involved in the exposure. These cases also had an increased incidence of any vascular injury (28 vs. 9; P = 0.04). There were no differences between groups regarding vascular injury type, repair type, or the incidence of deep venous thrombosis. Conclusion: Collaboration between spine and vascular teams may result in decreased blood loss and consequently improved morbidity and length of hospital stay.

UR - http://www.scopus.com/inward/record.url?scp=84875214165&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875214165&partnerID=8YFLogxK

U2 - 10.1016/j.avsg.2012.04.023

DO - 10.1016/j.avsg.2012.04.023

M3 - Article

C2 - 23084730

AN - SCOPUS:84875214165

VL - 27

SP - 306

EP - 313

JO - Annals of Vascular Surgery

JF - Annals of Vascular Surgery

SN - 0890-5096

IS - 3

ER -