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

Abstract

Background contextMinimally 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. PurposeTo determine the incidence of perioperaive complications with MIS-TLIF procedure based on our definition of Type I and II perioperative complications. Study designRetrospective cohort study; a review of complications. Patient sampleThe sample comprises 204 patients who underwent MIS-TLIF for the treatment of lumbar degenerative diseases. Outcome measuresType 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. MethodsA 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. ResultsThe 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. ConclusionsMinimally 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.