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Retroperitoneal approach to the lumbar spine1

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Nitin Paikrao
Nitin Paikrao
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RETROPERITONEAL APPROACH TO THE LUMBAR SPINE DR. ASHISH AGARWAL. DR.NITIN PAIKRAO. DEPT. OF ORTHOPAEDICS B.Y.L.NAIR CH. HOSPITAL
INDICATIONS FOR RETROPERITONEAL APPROCH l ,[object Object],[object Object],[object Object],[object Object],[object Object]
POSITION OF PATIENT ,[object Object],[object Object]
. ,[object Object],midline. Figure 6-31 Place the patient in the semilateral position for the anterolateral (retroperitoneal) approach to the lumbar
INCISION ,[object Object]
[object Object],posteriorly. Figure 6-33 Make an oblique flank incision extending down from the posterior half of the 12th rib toward the rectus abdominis muscle
SUPERFICIAL SURGICAL DISSECTION ,[object Object],[object Object]
[object Object],it. Figure 6-34 Incise the external oblique muscle and aponeurosis in line with its fibers and in line with the skin incision
. ,[object Object]
. ,[object Object]
[object Object],FIGURE 6-35 DIVIDE THE INTERNAL OBLIQUE IN LINE WITH THE SKIN INCISION AND PERPENDICULAR TO THE LINE OF ITS MUSCULAR FIBERS.
. ,[object Object]
. ,[object Object]
. ,[object Object],[object Object],[object Object],Figure 6-36 Divide the underlying transversus abdominis muscle in line with the skin incision.
DO NOT CUT TRANSVERSALIS FASCIA AS IT FORMS PROTECTIVE LAYER OVER THE PERITONEUM
. ,[object Object]
. ,[object Object],[object Object]
video
video
. ,[object Object]
video
. ,[object Object],[object Object]
. ,[object Object],[object Object]
. ,[object Object],[object Object]
IDENTIFY SEGMENTAL VESSEL TWO LAYERS OF PREVERTEBRAL FASCIA SEGMENTAL VESSELS IN BETWEEN
INFILTRATE PREVERTEBRAL FASCIA
video
INCISE ,[object Object],[object Object],[object Object]
DISSECTION OF SEGMENTAL VESSELS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SUBPERIOSTEAL DISSECTION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CAVEAT………… ,[object Object],[object Object],[object Object]
. ,[object Object],FRACTURE L2 VERTEBRA
 
[object Object],EXPANDIBLE CAGES
. ,[object Object]
L3 FRACTURE
L3 FRACTURE
 
 
L1 FRACTURE
L1 FRACTURE
 
 
[object Object],[object Object],[object Object],[object Object]
. ,[object Object]

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