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A new “keyhole” approach for multilevel anterior lumbar interbody fusion: the perinavel approach—technical note and literature review

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PurposeThe purpose of this study is to evaluate the feasibility and the safety of a new skin incision for minimally invasive anterior lumbar interbody fusion (ALIF): the perinavel incision.MethodsDemographic and… Click to show full abstract

PurposeThe purpose of this study is to evaluate the feasibility and the safety of a new skin incision for minimally invasive anterior lumbar interbody fusion (ALIF): the perinavel incision.MethodsDemographic and clinical data from patients who underwent ALIF with the perinavel incision were collected. Indications to surgery, preoperative symptoms, radiological data, number of treated levels, intraoperative and early postoperative complications and wound-related problems were analysed.ResultNinety-seven patients underwent ALIF with this new skin incision. One hundred fifty-seven levels were treated (mean 1.7 level per patient) being L4–L5 the most frequently treated. Intraoperative complications were represented only by the venous injury with a rate of 3.09% (3 cases). Postoperative complications were all linked to skin incision issues: a case of wound dehiscence and a case of superficial infection. No case of skin necrosis occurs at 3-month follow-up.ConclusionsIn this paper, the perinavel skin incision was demonstrated to be as safe as traditional approaches for ALIF. Furthermore, with this incision it is possible to perform multilevel (L3–S1) ALIF, which means a good option in minimally invasive surgery as well as revision surgery.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material.

Keywords: skin incision; perinavel; lumbar interbody; incision; approach; anterior lumbar

Journal Title: European Spine Journal
Year Published: 2018

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