Perioperative complications in patients undergoing open transforaminal lumbar interbody fusion as a revision surgery

Imad Saeed Khan, Ashish Sonig, Jai Deep Thakur, Papireddy Bollam, Anil Nanda

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Object. Transforaminal lumbar interbody fusion (TLIF) has been increasingly used to treat degenerative spine disease, including that in patients in whom earlier decompressive procedures have failed. Reexploration in these cases is always challenging and is thought to pose a higher risk of complications. To the best of the authors' knowledge, there are no current studies specifically analyzing the effects of previous lumbar decompressive surgeries on the complication rates of open TLIF. Methods. The authors performed a retrospective study of surgeries performed by a single surgeon. A total of 187 consecutive patients, in whom the senior author (A.N.) had performed open TLIF between January 2007 and January 2011, met the inclusion criteria. The patients were divided into two groups (primary and revision TLIF) for the comparison of perioperative complications. Results. Overall, the average age of the patients was 49.7 years (range 18-80 years). Of the 187 patients, 73 patients had no history of lumbar surgery and 114 were undergoing revision surgery. Fifty-four patients (28.9%) had a documented complication intraoperatively or postoperatively. There was no difference in the rate on perioperative complications between the two groups (overall, medical, wound related, inadvertent dural tears [DTs], or neural injury). Patients who had undergone more than one previous lumbar surgery were, however, more likely to have suffered from DTs (p = 0.054) and neural injuries (p = 0.007) compared with the rest. Conclusions. In the hands of an experienced surgeon, revision open TLIF does not necessarily increase the risk of perioperative complications compared with primary TLIF. Two or more previous lumbar decompressive procedures, however, increase the risk of inadvertent DTs and neural injury.

Original languageEnglish (US)
Pages (from-to)260-264
Number of pages5
JournalJournal of Neurosurgery: Spine
Volume18
Issue number3
DOIs
StatePublished - Mar 1 2013

Fingerprint

Reoperation
Tears
Wounds and Injuries
Spine
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Surgery
  • Neurology
  • Clinical Neurology

Keywords

  • Functional neurosurgery
  • Open transforaminal lumbar interbody fusion
  • Perioperative complications
  • Post-lumbar decompressive surgery
  • Revision surgery

Cite this

Khan, Imad Saeed ; Sonig, Ashish ; Thakur, Jai Deep ; Bollam, Papireddy ; Nanda, Anil. / Perioperative complications in patients undergoing open transforaminal lumbar interbody fusion as a revision surgery. In: Journal of Neurosurgery: Spine. 2013 ; Vol. 18, No. 3. pp. 260-264.
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Perioperative complications in patients undergoing open transforaminal lumbar interbody fusion as a revision surgery. / Khan, Imad Saeed; Sonig, Ashish; Thakur, Jai Deep; Bollam, Papireddy; Nanda, Anil.

In: Journal of Neurosurgery: Spine, Vol. 18, No. 3, 01.03.2013, p. 260-264.

Research output: Contribution to journalArticle

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AU - Sonig, Ashish

AU - Thakur, Jai Deep

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N2 - Object. Transforaminal lumbar interbody fusion (TLIF) has been increasingly used to treat degenerative spine disease, including that in patients in whom earlier decompressive procedures have failed. Reexploration in these cases is always challenging and is thought to pose a higher risk of complications. To the best of the authors' knowledge, there are no current studies specifically analyzing the effects of previous lumbar decompressive surgeries on the complication rates of open TLIF. Methods. The authors performed a retrospective study of surgeries performed by a single surgeon. A total of 187 consecutive patients, in whom the senior author (A.N.) had performed open TLIF between January 2007 and January 2011, met the inclusion criteria. The patients were divided into two groups (primary and revision TLIF) for the comparison of perioperative complications. Results. Overall, the average age of the patients was 49.7 years (range 18-80 years). Of the 187 patients, 73 patients had no history of lumbar surgery and 114 were undergoing revision surgery. Fifty-four patients (28.9%) had a documented complication intraoperatively or postoperatively. There was no difference in the rate on perioperative complications between the two groups (overall, medical, wound related, inadvertent dural tears [DTs], or neural injury). Patients who had undergone more than one previous lumbar surgery were, however, more likely to have suffered from DTs (p = 0.054) and neural injuries (p = 0.007) compared with the rest. Conclusions. In the hands of an experienced surgeon, revision open TLIF does not necessarily increase the risk of perioperative complications compared with primary TLIF. Two or more previous lumbar decompressive procedures, however, increase the risk of inadvertent DTs and neural injury.

AB - Object. Transforaminal lumbar interbody fusion (TLIF) has been increasingly used to treat degenerative spine disease, including that in patients in whom earlier decompressive procedures have failed. Reexploration in these cases is always challenging and is thought to pose a higher risk of complications. To the best of the authors' knowledge, there are no current studies specifically analyzing the effects of previous lumbar decompressive surgeries on the complication rates of open TLIF. Methods. The authors performed a retrospective study of surgeries performed by a single surgeon. A total of 187 consecutive patients, in whom the senior author (A.N.) had performed open TLIF between January 2007 and January 2011, met the inclusion criteria. The patients were divided into two groups (primary and revision TLIF) for the comparison of perioperative complications. Results. Overall, the average age of the patients was 49.7 years (range 18-80 years). Of the 187 patients, 73 patients had no history of lumbar surgery and 114 were undergoing revision surgery. Fifty-four patients (28.9%) had a documented complication intraoperatively or postoperatively. There was no difference in the rate on perioperative complications between the two groups (overall, medical, wound related, inadvertent dural tears [DTs], or neural injury). Patients who had undergone more than one previous lumbar surgery were, however, more likely to have suffered from DTs (p = 0.054) and neural injuries (p = 0.007) compared with the rest. Conclusions. In the hands of an experienced surgeon, revision open TLIF does not necessarily increase the risk of perioperative complications compared with primary TLIF. Two or more previous lumbar decompressive procedures, however, increase the risk of inadvertent DTs and neural injury.

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KW - Open transforaminal lumbar interbody fusion

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KW - Post-lumbar decompressive surgery

KW - Revision surgery

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