Central Surgical Association| Volume 128, ISSUE 4, P589-596, October 2000

Efficacy of the laparoscopic approach for anterior lumbar spinal fusion


      Background. This study compares the immediate postoperative outcomes in patients who undergo laparoscopic and open anterior lumbar spinal fusion and describes the learning curve associated with the performance of this procedure. Methods. The charts of patients who underwent anterior lumbar spinal fusion between January 1995 and July 1999 were reviewed. Data pertaining to the operation and postoperative course were analyzed and compared. Results. Eighty-nine patients underwent anterior lumbar spinal fusion. Fourteen patients were excluded; a full analysis was performed on the records of the remaining 75 patients. Fifty-five patients underwent an attempted laparoscopic procedure, and 20 patients underwent an open procedure. The conversion rate was 38% (21/55 patients) in the group who underwent the laparoscopic procedure. In the 34 patients whose laparoscopic procedure was completed, there was significantly less blood loss and shorter postoperative ileus, but the operative time was longer, when compared with patients who underwent the open procedure. The laparoscopic procedures performed in 1999 resulted in fewer conversions, less blood loss, and a shorter operating room time, when compared with the laparoscopic procedures in 1998. Conclusions. Laparoscopic anterior lumbar spinal fusion improves immediate postoperative results when compared with open anterior lumbar spinal fusion. (Surgery 2000;128:589-96.)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Flynn JC
        • Hoque MA
        Anterior fusion of the lumbar spine.
        J Bone Joint Surg. 1979; 61: 1143-1150
        • Gadacz TR
        US experience with laparoscopic cholecystectomy.
        Am J Surg. 1993; 165: 450-454
        • Samkoff JS
        • Wu B
        Laparoscopic and open cholecystectomy outcomes in medicare beneficiaries in member states of the large state PRE consortium.
        Am J Med Qual. 1995; 10: 183-189
        • Watson DI
        • Jamieson GG
        Antireflux surgery in the laparoscopic era.
        Br J Surg. 1998; 85: 1173-1184
        • Obenchain TG
        Laparoscopic lumbar discectomy: case report.
        J Laparoendosc Surg. 1991; 1: 145-149
        • Cloyd DW
        • Obenchain TG
        • Savin M
        Transperitoneal laparoscopic approach to lumbar discectomy.
        Surg Laparosc Endosc. 1995; 5: 85-89
        • Matthews HH
        • Evans MT
        • Molligan HJ
        • Long BH
        Laparoscopic discectomy with anterior interbody fusion: a preliminary review.
        Spine. 1995; 20: 1797-1802
        • McAfee PC
        • Regan JJ
        • Zdeblick TA
        • Zuckerman J
        • Picetti GD
        • Heim S
        • et al.
        The incidence of complications in endoscopic anterior thoracolumbar spinal reconstructive surgery: a prospective multicenter study comprising the first 100 consecutive cases.
        Spine. 1995; 20: 1624-1632
        • Slotman GJ
        • Stein SC
        Laparoscopic lumbar discectomy: preliminary report of a minimally invasive anterior approach to the herniated L5-S1 disk.
        Surg Laparosc Endosc. 1995; 5: 363-369
        • Mahvi DM
        • Zdeblick TA
        A prospective study of laparoscopic spinal fusion: technique and operative considerations.
        Ann Surg. 1996; 224: 85-90
        • Regan JJ
        • Yuan H
        • McAfee PC
        Laparoscopic fusion of the lumbar spine: minimally invasive spine surgery: a prospective multicenter study evaluating open and laparoscopic lumbar fusion.
        Spine. 1999; 24: 402-411
        • Katkhouda N
        • Campos GMR
        • Mavor E
        • Mason RJ
        • Hume M
        • Ting A
        Is laparoscopic approach to lumbar spine fusion worthwhile?.
        Am J Surg. 1999; 178: 458-461
        • Reddick EA
        • Olsen DO
        Laparoscopic laser cholecystectomy: a comparison with mini-lap cholecystectomy.
        Surg Endosc. 1989; 3: 131-133