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Lateral interbody fusion without intraoperative neuromonitoring in addition to posterior instrumented fusion in geriatric patients: A single center consecutive series of 108 surgeries

INTRODUCTION: Lateral lumbar interbody fusion (LLIF) and lateral thoracic interbody fusion (LTIF), supported by intraoperative neuromonitoring (IONM), gained popularity as a mini-invasive alternatives for standard interbody fusion. The objective of this study was to investigate the clinical outcome...

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Autores principales: Bobinski, Lukas, Liv, Per, Meyer, Bernhard, Krieg, Sandro M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668059/
https://www.ncbi.nlm.nih.gov/pubmed/38021016
http://dx.doi.org/10.1016/j.bas.2023.101782
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author Bobinski, Lukas
Liv, Per
Meyer, Bernhard
Krieg, Sandro M.
author_facet Bobinski, Lukas
Liv, Per
Meyer, Bernhard
Krieg, Sandro M.
author_sort Bobinski, Lukas
collection PubMed
description INTRODUCTION: Lateral lumbar interbody fusion (LLIF) and lateral thoracic interbody fusion (LTIF), supported by intraoperative neuromonitoring (IONM), gained popularity as a mini-invasive alternatives for standard interbody fusion. The objective of this study was to investigate the clinical outcome in a large elderly patient cohort who underwent LTIF/LLIF without IONM. METHODS: This retrospective, single-center study enrolled elderly patients (≥70 years old) operated during the period from 2010 to 2016. Anterior lumbar interbody fusion (ALIF) in the L5/S1 segment was excluded from the analysis. RESULTS: The study enrolled 108 patients (63 males, 58.3%) with a mean age of 76.5 ​y/o. The mean follow-up was 14.4 ​± ​11.3 months. The mean time of the surgery was 92 ​± ​34.2 ​min. The mean blood loss was 62.2 ​ml. There were no vascular or visceral surgical complications. 39 medical complications were encountered in 24 (22%) patients. Less than 5% of patients presented with a new onset of motor weakness and less than 2% of the patients developed a new sensory deficit at the discharge. 46% of patients were lost in follow-up at 12 months. CONCLUSIONS: IONM is not mandatory for LLIF/LTIF surgery in geriatric patients and has a low frequency of approach-related complications as well as neurological deterioration. Our results are comparable to the available literature. Regardless of the utilization of these mini-invasive, anterior approaches, in patients of advanced aged, the risk for major medical complications is high and is responsible for contributing to prolonged hospitalization.
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spelling pubmed-106680592023-07-11 Lateral interbody fusion without intraoperative neuromonitoring in addition to posterior instrumented fusion in geriatric patients: A single center consecutive series of 108 surgeries Bobinski, Lukas Liv, Per Meyer, Bernhard Krieg, Sandro M. Brain Spine Article INTRODUCTION: Lateral lumbar interbody fusion (LLIF) and lateral thoracic interbody fusion (LTIF), supported by intraoperative neuromonitoring (IONM), gained popularity as a mini-invasive alternatives for standard interbody fusion. The objective of this study was to investigate the clinical outcome in a large elderly patient cohort who underwent LTIF/LLIF without IONM. METHODS: This retrospective, single-center study enrolled elderly patients (≥70 years old) operated during the period from 2010 to 2016. Anterior lumbar interbody fusion (ALIF) in the L5/S1 segment was excluded from the analysis. RESULTS: The study enrolled 108 patients (63 males, 58.3%) with a mean age of 76.5 ​y/o. The mean follow-up was 14.4 ​± ​11.3 months. The mean time of the surgery was 92 ​± ​34.2 ​min. The mean blood loss was 62.2 ​ml. There were no vascular or visceral surgical complications. 39 medical complications were encountered in 24 (22%) patients. Less than 5% of patients presented with a new onset of motor weakness and less than 2% of the patients developed a new sensory deficit at the discharge. 46% of patients were lost in follow-up at 12 months. CONCLUSIONS: IONM is not mandatory for LLIF/LTIF surgery in geriatric patients and has a low frequency of approach-related complications as well as neurological deterioration. Our results are comparable to the available literature. Regardless of the utilization of these mini-invasive, anterior approaches, in patients of advanced aged, the risk for major medical complications is high and is responsible for contributing to prolonged hospitalization. Elsevier 2023-07-11 /pmc/articles/PMC10668059/ /pubmed/38021016 http://dx.doi.org/10.1016/j.bas.2023.101782 Text en © 2023 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bobinski, Lukas
Liv, Per
Meyer, Bernhard
Krieg, Sandro M.
Lateral interbody fusion without intraoperative neuromonitoring in addition to posterior instrumented fusion in geriatric patients: A single center consecutive series of 108 surgeries
title Lateral interbody fusion without intraoperative neuromonitoring in addition to posterior instrumented fusion in geriatric patients: A single center consecutive series of 108 surgeries
title_full Lateral interbody fusion without intraoperative neuromonitoring in addition to posterior instrumented fusion in geriatric patients: A single center consecutive series of 108 surgeries
title_fullStr Lateral interbody fusion without intraoperative neuromonitoring in addition to posterior instrumented fusion in geriatric patients: A single center consecutive series of 108 surgeries
title_full_unstemmed Lateral interbody fusion without intraoperative neuromonitoring in addition to posterior instrumented fusion in geriatric patients: A single center consecutive series of 108 surgeries
title_short Lateral interbody fusion without intraoperative neuromonitoring in addition to posterior instrumented fusion in geriatric patients: A single center consecutive series of 108 surgeries
title_sort lateral interbody fusion without intraoperative neuromonitoring in addition to posterior instrumented fusion in geriatric patients: a single center consecutive series of 108 surgeries
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668059/
https://www.ncbi.nlm.nih.gov/pubmed/38021016
http://dx.doi.org/10.1016/j.bas.2023.101782
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