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Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
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Retrograde ejaculation after anterior lumbar spine surgery.

Emily M Lindley1, Zachary L McBeth, Sarah E Henry

  • 1Department of Orthopaedics, The Spine Center, University of Colorado Denver, Anschutz Medical Campus, Denver, CO, USA. emily.lindley@ucdenver.edu

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Anterior lumbar spine surgery using bone morphogenetic protein (BMP) or artificial disc replacement (ADR) resulted in similar rates of retrograde ejaculation (RE). Patients undergoing these anterior lumbar procedures should be counseled on the risk of RE.

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Area of Science:

  • Spine surgery outcomes
  • Urological complications
  • Spinal fusion techniques

Background:

  • Anterior lumbar interbody fusion (ALIF) is a common spinal procedure, but can lead to retrograde ejaculation (RE).
  • The use of bone morphogenetic protein-2 (BMP) in ALIF has raised questions about its potential to increase RE risk.
  • Artificial disc replacement (ADR) is an alternative anterior lumbar procedure.

Purpose of the Study:

  • To compare the incidence of retrograde ejaculation (RE) after anterior lumbar spine surgery.
  • To evaluate RE rates between anterior lumbar interbody fusion with bone morphogenetic protein-2 (BMP) and artificial disc replacement (ADR).

Main Methods:

  • Retrospective cohort study of male patients undergoing ALIF with BMP or ADR at L5-S1 between 2004 and 2011.
  • Evaluation of medical records for postoperative RE occurrence.
  • Phone contact with patients for current RE status.

Main Results:

  • 95 patients included: 54 (56.8%) ALIF with BMP, 41 (43.2%) ADR.
  • Postoperative RE occurred in 7.4% of ALIF with BMP patients and 9.8% of ADR patients.
  • No significant difference in RE incidence between the two groups (P = 0.7226).

Conclusions:

  • Retrograde ejaculation (RE) rates were similar for both artificial disc replacement (ADR) and anterior lumbar interbody fusion with bone morphogenetic protein-2 (BMP).
  • The overall incidence of RE after retroperitoneal anterior lumbar surgery was higher than anticipated.
  • Patient counseling regarding RE risk and postoperative symptom assessment is crucial.