Two level Anterior Lumbar Interbody Fusion (ALIF) in a patient with a rare vascular malformation, a duplication of the inferior vena cava

• Published in: Neuro-chirurgie Vol. 66; no. 6; pp. 466 - 470
• Main Authors: Chapon, R., Bousquet, O., Beaurain, J., Alixant, P., Madkouri, R., Grelat, M.
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01-12-2020; Elsevier Masson
• Subjects: Anterior Lumbar Interbody Fusion; Duplication inferior vena cava; Life Sciences; Spine surgery complications; Vascular anomalies; Anterior Lumbar Interbody Fusion; Vascular anomalies; Duplication inferior vena cava; Spine surgery complications
• ISSN: 0028-3770; 1773-0619
• DOI: 10.1016/j.neuchi.2020.08.010

Anterior Lumbar Interbody Fusion is now a well-established procedure to treat degenerative lumbar disease. This approach has its own risks and each spine surgeon must understand the pitfalls that can be encountered when dealing with an anatomy variation of the vessels in order to be able to perform the safest possible procedure.
We report the case of a 48 years old man with a rare vascular anatomy variation undergoing a two-levels L4-L5 and L5-S1 ALIF procedure through a right-sided retroperitoneal approach. The preoperative imaging planning revealed a duplication of the Inferior Vena Cava (IVC) located on each side of the aorta.
Preoperative Imaging evaluation and a detailed knowledge of the anatomy is the key of a safe and successful procedure as any variation can complicate the anterior approach. We believe that teaming up with a vascular surgeon for junior surgeons during the first anterior procedures and especially in the context of anatomical variation is recommended.