Technique for exposing lumbar discs in anterior approach using Steinmann's wires: arthroplasties or arthrodesis.

Dias Pereira Filho, Aecio Rubens

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 methods 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 is to describe a technique for retracting abdominal structures by anterior approaches to the lumbar spine using Steinmann's wires. METHODS This manuscript consists in 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 due to anterior approach, either for arthrodesis/ALIF 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. CONCLUSION The technique described is safe, inexpensive and reproducible. Simple and easily accessible instruments are required in most hospital complexes.