Perioperative complications related to minimally invasive transforaminal lumbar fusion: evaluation of 204 operations on lumbar instability at single center.

BACKGROUND CONTEXT

Minimally invasive transforaminal lumbar fusion (MIS-TLIF) has demonstrated efficacy in the treatment of lumbar degenerative diseases. The reported incidence of perioperative complications associated with MIS-TLIF surgery is highly variable. Studies concerning perioperative complications in broad patient populations are quite rare. This study analyzes a retrospectively collected database of patients who underwent an MIS-TLIF surgery at a single center.

PURPOSE

To determine the incidence of perioperaive complications with MIS-TLIF procedure based on our definition of Type I and II perioperative complications.

STUDY DESIGN

Retrospective cohort study; a review of complications.

PATIENT SAMPLE

The sample comprises 204 patients who underwent MIS-TLIF for the treatment of lumbar degenerative diseases.

OUTCOME MEASURES

Type I complication including all medical adverse events without direct connection to the specific surgical procedure performed. Type II complication including adverse events with direct connection to the surgical procedure performed.

METHODS

A total of 204 MIS-TLIF surgeries on lumbar instability or spondylolisthesis, performed between June 2007 and July 2012, were examined in a retrospective study. A complication classification based on the relation to the surgical procedure and the effect duration was used. Perioperative complications until 1 month postoperatively were reviewed for the patients.

RESULTS

The study group comprised 204 patients (106 women, 98 men; mean age at surgery, 52.4 years; age range, 39-84 years). Overall, there were 75 perioperative complications in 204 patients (36.76%). Only one complication occurred in 54 patients. Nine patients had two complications. One patient had three complications. The incidence of perioperative complication was 31.37% (64/204 patients) in the MIS-TLIF operations. Of all complications, seven (9.33%) were classified as persistent complications and 68 (90.67%) were classified as transient complications. The incidence of Type I and II complications were 13.73% and 23.04%, respectively.

CONCLUSIONS

Minimally invasive transforaminal lumbar fusion has gained popularity as a procedure for the treatment of lumbar instability or spondylolisthesis, with similar complications as in the open surgery. Transient sensory disturbance was the most common complication in this series.