Technique for Exposing Lumbar Discs in Anterior Approach Using Steinmann Wires: Arthroplasties or Arthrodesis

BACKGROUND: Due to increasing longevity, the incidence of degenerative lumbar disc diseases has increased, and surgical treatment is often necessary. In this context, the anterior approach becomes an important technique. However, one of the main limitations of this method is the need for dedicated retractors, which requires larger incisions for its positioning and increases the cost of the procedure. The objective of the present study was to describe a technique for retracting abdominal structures by anterior approaches to the lumbar spine using Steinmann wires. METHODS: This manuscript consists of a technique description of anterior approach for lumbar spine. RESULTS: Surgical treatment of degenerative lumbar spine disease is often necessary when the patients have symptoms refractory to conservative treatments. Many of them will be candidates for surgical treatment with anterior approach, either for arthrodesis/anterior lumbar interbody fusion or arthroplasty. Small incisions are performed for positioning the modified Langenbeck retractors and the Steinmann wires. These retractors are easily positioned and provide good exposure of the lumbar discs making it possible to implant appropriate cages for restoring the necessary height, lordosis, and sagittal balance. CONCLUSIONS: The technique described is safe, inexpensive, and reproducible. Simple and easily accessible instruments are required in most hospital complexes.

Automated summary

The study describes a technique for retracting abdominal structures by anterior approaches to the lumbar spine using Steinmann wires, which is necessary for surgical treatment of degenerative lumbar disc diseases. This technique involves small incisions for positioning modified Langenbeck retractors and Steinmann wires, providing good exposure of the lumbar discs for implanting appropriate cages to restore necessary height, lordosis, and sagittal balance. The described technique is safe, inexpensive, and reproducible, requiring simple and easily accessible instruments in most hospital complexes.