Anterior lumbar interbody fusion: single institutional review of complications and associated variables |
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| Institution: | 1. Georgetown University School of Medicine, 3900 Reservoir Rd, Washington, DC, USA;2. Department of Neurosurgery, 3800 Reservoir Rd, MedStar Georgetown University Hospital, Washington, DC, USA;3. Division of Neurosurgery, 16001 W Nine Mile Rd, Ascension Providence Hospital, College of Human Medicine, Michigan State University, Southfield, MI, USA;4. Department of Neurological Surgery, 200 1st St NW, Mayo Clinic, Rochester, MN, USA;5. Division of Thoracic Surgery, 3800 Reservoir Rd, MedStar Georgetown University Hospital, Washington, DC, USA;1. Department of Orthopedic Surgery, Guri Hospital, Hanyang University College of Medicine, 153 Gyeongchun-ro, Guri-si, Gyeonggi-do 11923, South Korea;2. Department of Orthopedics, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea;1. Washington University School of Medicine, St Louis, MO;2. Children''s Hospital Los Angeles, Los Angeles, CA;3. Shriners Hospitals for Children – Philadelphia, Philadelphia, PA;4. IWK Health Center, Halifax, Nova Scotia;1. Department of Orthopaedic Surgery, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block Level 11, Singapore 119228;2. National University of Singapore Engineering Programme (NUSTEP), Department of Orthopedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore (NUS), 10 Medical Dr, Singapore 117597;3. Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), 10 Medical Dr, Singapore 117597;4. Institute of Medical Biology (IMB), Agency for Science, Technology and Research (A*STAR), 8a Biomedical Grove, Singapore 138648;5. Bruker Singapore Pte Ltd, Singapore, 30 Biopolis St, Singapore 138671;1. Division of Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA;2. Neurosurgical Associates of Lancaster, Lancaster, PA, USA;3. Abbott Neuromodulation, Austin, TX, USA;4. Connecticut Orthopaedics, Hamden, CT, USA |
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| Abstract: | BACKGROUND CONTEXTAs more patients undergo anterior lumbar interbody fusion (ALIF) procedures and more devices are created for that purpose, it is important to understand the complications that can arise and the variables that mitigate risk for major and minor complications.PURPOSETo assess complication rates after ALIF with or without posterior instrumentation and variables associated with increased likelihood of postoperative complications. We aim to provide this data as benchmarking to improve patient safety and surgical care.STUDY DESIGNA single-center retrospective cohort study.PATIENT SAMPLEAll adult patients who underwent ALIF between 2017 and 2019 was performedOUTCOME MEASURESPost-operative major and minor complications were evaluated.METHODSComplications were recorded and presented as percentages. Patient demographics, perioperative, and postoperative data were also collected and analyzed between patients who had no complications and those that had any complication. Subgroup analysis of surgical complications were performed by nonparametric Chi-square tests. Continuous variables were compared using Mann-Whitney U tests.RESULTSNinty-five of three hundred sixty-two (26.2%) of patients experienced a minor or major complication. Among the most common complications found were surgical site infections (5.8%), neurological complications (4.1%), vascular complications (3.6%), and urinary tract infections (3.3%). Patients undergoing ALIF alone with post-operative complications had higher mean age, higher BMI, higher ASA status, and experienced higher estimated blood loss. Patients undergoing ALIF and posterior instrumentation with post-operative complications were more likely to have diabetes and had a higher ASA status. Patients with any complications from both groups had longer length of stay, discharge to a non-home setting and were more likely to be readmitted or return to the operating room.CONCLUSIONOur study reveals variables associated with complications at our institution, including age of the patient, BMI, and ASA status leading to higher complications and greater LOS, higher readmission rates, and disposition to skilled facilities. |
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