Outcome After Extreme Lateral Transpsoas Approach: Corpectomies Versus Interbody Fusion

Abstract

The lateral transpsoas approach (LTPA) has gained popularity in thoracolumbar spine surgery procedures; however, there is an insufficient amount of data pertaining to motor and sensory complications that arise when a corpectomy is performed through the LTPA approach. Patients who underwent a corpectomy through a LTPA at a single institution between 2006 and 2016 were analyzed. Demographics, neurological outcomes, and complications were recorded. The minimum follow-up was 6 months. Univariate analysis was performed to compare demographics, surgical characteristics, complications, and outcome scores. To compare categorical variables, the χ2 test was used. For continuous outcomes, simple linear regression was used. Statistical significance was set at P < 0.05. A total of 166 patients were included. The patients were divided into 2 groups; LTPA without corpectomy (n= 112) versus LTPA with corpectomy (n=54). Patients without corpectomy showed a significantly lower rate of postoperative infections compared with patients with corpectomy (3.6% vs. 22.2%; P < 0.000). A higher percentage of postoperative complications wasfound in patients with corpectomy (31.5% vs. 13.4%; P= 0.006). Therate of neurologic complications at the 6-month follow-up and the reoperation rate (22.7% vs. 32.4%; P= 0.256) were higher in the corpectomy group (8.9% vs. 7.4%; P= 0.741), no significant difference was found between the groups. Patients who underwent an LTPA corpectomy have a higher risk to suffer from postoperative complications. The results at the 6-month follow-up did not significantly differ between the groups.