11 Anterior Excision and Vertebral Body Fusion Operation for Intervertebral Disk Syndromes of the Lower Lumbar Spine

Abstract

Fig. 10 Halftone drawings, demonstrating a transvertebral grafting procedure on the anterior aspect of the lumbosacral joint. The lower right-hand figure shows insertion of full -thickness iliac graft, ‘‘coin’’ type. Two such grafts per level are preferred. If the most superficial (ventral) graft cannot be countersunk to more than one-eighth inch below the vertebral margin, screw fixation, oblique at a 45-degree angle through graft and into sacral body is recommended. (Reprinted with permission and Lippincott Williams & Wilkins, from Harmon, PH. Anterior excision and vertebral body fusion operation for intervertebral disk syndromes of the lower lumbar spine: three to five year results in 244 cases. Clin Orthop Relat Res. 1963;26:107–127.) Fig. 11 An alternative technique of preparation of graft bed and insertion of 2 rectangular grafts illustrated for the L-4 level: (A) incision in the anterior ligament; (B) preparation of graft bed; (C) completed grafting procedure. (Reprinted with permission and Lippincott Williams & Wilkins, from Harmon, PH. Anterior excision and vertebral body fusion operation for intervertebral disk syndromes of the lower lumbar spine: three to five year results in 244 cases. Clin Orthop Relat Res. 1963;26:107–127.) Published online: 31 March 2012 The Association of Bone and Joint Surgeons1 2012