Article Figures & Data
Figures
- Figure 1
Intraoperative photograph showing a standard vascular dissection between a vein (secured with vascular retraction pins) and the smooth periosteum to expose the L5-S1 disc with a midline pin.
- Figure 2
Intraoperative photograph demonstrating a difficult vascular dissection that features thickened, “gritty” inflammation and the loss of the usual periosteal sheen, requiring a subperiosteal surgical approach to safely expose the L5-S1 disc.
Tables
Characteristic Values Age in years, mean (SD, range) 42.5 (11.9, 21–81) Male, n (%) 124 (50) BMI, mean (SD, range) 26.2 (3.8, 19–37) Comorbidities, n (%) Ex-smoker 83 (34) Current smoker 38 (15) Never smoker 125 (51) Prior microdiscectomy, n (%) 17 (7) Vascular adherence/dissection difficulty, n (%) Standard 203 (82) Difficult 43 (18) Blood loss (mL) Standard dissection Single-level mean (SD, range) 126.6 (116.8, 20–490) Two-level mean (SD, range) 188.9 (202.6, 50–650) Difficult dissection Single-level mean (SD, range) 160.3 (280.7, 10–1420) Two-level mean (SD, range) 347.5 (355.3, 20–1550) Type of operation, n (%) ALIF 117 (48) TDR 69 (28) Hybrid 60 (24) Level of operation, n (%) Single-level L4-5 50 (20) L5-S1 121 (49) Two-level L3-4 and L4-5 2 (1) L4-5 and L5-S1 73 (30) Modic changes, n (%) Type 1 11 (4) Type 2 57 (23) ALIF, anterior lumbar interbody fusion; BMI, body mass index; TDR, total disc replacement.
Factor P Value Age 0.0981 Sex 0.7377 BMI 0.2497 Smoking status 0.0072 Prior microdiscectomy 0.9009 Level 0.9737 Modic Type 1 changes 0.1266 Modic Type 2 changes 0.0085 BMI, body mass index.
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