Lateral Gutter Spine

It is most commonly done at l4 through l5 or l5 through s1 as these are the segments most likely to degenerate.

Lateral gutter spine.

Anterolateral ankle impingement has been known under the term anterolateral meniscoid lesion which is the result of synovitis in the anterolateral gutter. Impingement after tar can be a source of pain and decreased patient satisfaction which in turn results in poor outcomes 1 impingement is of an unknown complex etiology and is likely multifactorial. Medial and lateral gutter ankle impingement may result after total ankle replacement tar. The patient is prone and the incision is made overlying the vertebrae.

A lumbar posterolateral gutter fusion is done in the lower back at l1 through l2 through l5 through s1 at the bottom of the spine. Often nonoperative management is not successful in the setting of impingement after tar. Sometimes this type of fusion procedure may be referred to as a gutter fusion or the placement of the bone graft referred to as in the gutters these procedures allow for posterior column fusion through a posterior posterolateral or lateral transverse approach. It is an uncommon cause of chronic lateral ankle pain 6 typically seen in athletes 3 5.

Most spine surgeons work through the same incision to obtain the bone graft and to perform the spinal fusion. First bone graft is obtained from the pelvis the iliac crest although some form of bone graft substitute may also be used. In a posterolateral gutter fusion the surgical approach to the spine is from the back through a midline incision that is approximately three inches to six inches long. In spinal fusion surgery the doctor implants either a device or bone material to help re stabilize the spine.