The spine journal : official journal of the North American Spine Society
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Since the introduction of threaded devices in the mid-1990s, anterior lumbar interbody fusion (ALIF) has become a staple in the armamentarium of the spine surgeon. The procedure, however, is heavily dependent on the ability of the approach surgeon to provide exposure quickly and safely in view of a reported incidence of vascular injury as high as 15% and 2.3% incidence of retrograde ejaculation. ⋯ This experience suggests that a well-planned small incision that preserves the musculature can be performed quickly and safely to allow the spine surgeon adequate access to the anterior lumbar spine. The learning curve, however, can be high even for experienced surgeons.
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Techniques in current use for expansive laminoplasty operations (ELAP) on the cervical spine damage the extensor mechanisms, resulting in restriction of neck motion, loss of lordosis and persistent axial pains. ⋯ Skip laminectomy for cervical spinal canal decompression is less invasive than conventional laminectomy and ELAP. It is effective in preventing postoperative problems, such as persistent axial symptoms, restriction of neck motion and loss of cervical lordosis.