Research Article Outcomes and Complications of the Midline Anterior Approach 3 Years after Lumbar Spine Surgery Charla R. Fischer, 1 Brian Braaksma, 2 Austin Peters, 3 Jeffrey H. Weinreb, 4 Matthew Nalbandian, 5 Jeffrey M. Spivak, 5 and Anthony Petrizzo 5 1 Columbia University Medical Center, New York, NY 10032, USA 2 Rockford Orthopedic, Rockford, IL 61107, USA 3 Oregon Health and Science University, Portland, OR 97239, USA 4 University of Connecticut Health Center, Farmington, CT 06030, USA 5 New York University, Hospital for Joint Diseases, New York, NY 10003, USA Correspondence should be addressed to Charla R. Fischer; cdr2112@columbia.edu Received 2 September 2014; Accepted 3 November 2014; Published 22 December 2014 Academic Editor: Allen L. Carl Copyright © 2014 Charla R. Fischer et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. he purpose of this study was to evaluate a new questionnaire to assess outcomes related to the midline anterior lumbar approach and to identify risk factors for negative patient responses. Methods. A retrospective review of 58 patients who underwent anterior lumbar surgery at a single institution for either degenerative disc disease or spondylolisthesis in 2009 was performed. he outcome measures included our newly developed Anterior Lumbar Surgery Questionnaire (ALSQ), ODI, and EQ-5D. Results. here were 58 patients available for followup, 27 women and 31 men. he average age at surgery was 50.8 years, with an average followup of 2.92 years. he average change in ODI was 34.94 (22.7) and EQ-5D was 0.28 (0.29). he rate of complications with the anterior approach was 10.3% and there was one male patient (3.2%) with retrograde ejaculation. Determination of the efectiveness of the new ALSQ revealed that it signiicantly correlated to the EQ-5D and ODI ( < 0.05). Smoking was associated with a negative response on thirteen questions. BMP use was not associated with a negative response on any sexual function questions. Conclusions. Our new Anterior Lumbar Surgery Questionnaire determines patient perceived complications related to the midline anterior lumbar surgical approach. 1. Introduction he anterior approach to the lumbar spine is a versatile exposure that can be utilized to access the lumbar vertebrae and disc spaces for multiple indications and is a preferred method of approach for a variety of spinal conditions and procedures [1–7]. he anterior surgical approach to the lumbar spine presents a unique set of potential complications that must be considered and discussed with the patient when selecting a surgical treatment plan for spinal disorders. hese anterior approach speciic complications include peritoneal perforation or damage to local nerves including the superior hypogastric plexus and the paraspinal sympathetic lumbar chain and lumbosacral plexus. Depending on the level approached, various vascular elements including the inferior vena cava, common iliac vein, ascending iliolumbar vein, low lumbar segmental vessels, and the middle sacral vessels must also be addressed to avoid vascular complications [8]. While the intraoperative surgical complications (bowel and vascular injury) related to the anterior lumbar approach have been well documented [1, 4–7, 9–15], there has been a paucity of literature related to the patient perceived post- operative diiculties and complications associated with the approach. hese issues include incisional pain, change in bowel habits, and sexual dysfunction. In discussing surgical approach options, it is important to provide patients with as much information as possible to ensure that they can make an informed decision. Our new questionnaire addresses postoperative satisfaction, which may be afected by nerve damage or incision location. Patient dissatisfaction may Hindawi Publishing Corporation Advances in Orthopedics Volume 2014, Article ID 142604, 10 pages http://dx.doi.org/10.1155/2014/142604