Midline Anterior Approach From the Right Side to the Lumbar Spine for Interbody Fusion and Total Disc Replacement: A New Mobilization Technique of the Vena Cava
Edgard–Rosa G et al. – The midline anterior retroperitoneal approach from the right side is a safe alternative compared with the classical approach from the left side. The low rate of venous injury is explained by the sidewall thickness of the vena cava compared with the left iliac vein sidewall. Contrary to what happens by left–sided approach, the vascular retraction required for access to L4–L5 and above does not lead to arterial occlusion and therefore diminishes the risk in atheromatous patients. The absence of retrograde ejaculation confirms previous studies conducted on the left anastomosis of the superior hypogastric plexus, suggesting that its approach and mobilization by the left side are delicate.