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Perioperative Surgical Complications and Learning Curve Associated with Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Single-Institute Experience

BACKGROUND: As surgical complications tend to occur more frequently in the beginning stages of a surgeon's career, knowledge of perioperative complications is important to perform a safe procedure, especially if the surgeon is a novice. We sought to identify and describe perioperative complicat...

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Autores principales: Park, Yung, Lee, Soo Bin, Seok, Sang Ok, Jo, Byung Woo, Ha, Joong Won
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Orthopaedic Association 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4329539/
https://www.ncbi.nlm.nih.gov/pubmed/25729524
http://dx.doi.org/10.4055/cios.2015.7.1.91
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author Park, Yung
Lee, Soo Bin
Seok, Sang Ok
Jo, Byung Woo
Ha, Joong Won
author_facet Park, Yung
Lee, Soo Bin
Seok, Sang Ok
Jo, Byung Woo
Ha, Joong Won
author_sort Park, Yung
collection PubMed
description BACKGROUND: As surgical complications tend to occur more frequently in the beginning stages of a surgeon's career, knowledge of perioperative complications is important to perform a safe procedure, especially if the surgeon is a novice. We sought to identify and describe perioperative complications and their management in connection with minimally invasive transforaminal lumbar interbody fusion (TLIF). METHODS: We performed a retrospective chart review of our first 124 patients who underwent minimally invasive TLIF. The primary outcome measure was adverse events during the perioperative period, including neurovascular injury, implant-related complications, and wound infection. Pseudarthroses and adjacent segment pathologies were not included in this review. Adverse events that were not specifically related to spinal surgery and did not affect recovery were also excluded. RESULTS: Perioperative complications occurred in 9% of patients (11/124); including three cases of temporary postoperative neuralgia, two deep wound infections, two pedicle screw misplacements, two cage migrations, one dural tear, and one grafted bone extrusion. No neurologic deficits were reported. Eight complications occurred in the first one-third of the series and only 3 complications occurred in the last two-thirds of the series. Additional surgeries were performed in 6% of patients (7/124); including four reoperations (two for cage migrations, one for a misplaced screw, and one for an extruded graft bone fragment) and three hardware removals (one for a misplaced screw and two for infected cages). CONCLUSIONS: We found perioperative complications occurred more often in the early period of a surgeon's experience with minimally invasive TLIF. Implant-related complications were common and successfully managed by additional surgeries in this series. We suggest greater caution should be exercised to avoid the potential complications, especially when surgeon is a novice to this procedure.
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spelling pubmed-43295392015-03-01 Perioperative Surgical Complications and Learning Curve Associated with Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Single-Institute Experience Park, Yung Lee, Soo Bin Seok, Sang Ok Jo, Byung Woo Ha, Joong Won Clin Orthop Surg Original Article BACKGROUND: As surgical complications tend to occur more frequently in the beginning stages of a surgeon's career, knowledge of perioperative complications is important to perform a safe procedure, especially if the surgeon is a novice. We sought to identify and describe perioperative complications and their management in connection with minimally invasive transforaminal lumbar interbody fusion (TLIF). METHODS: We performed a retrospective chart review of our first 124 patients who underwent minimally invasive TLIF. The primary outcome measure was adverse events during the perioperative period, including neurovascular injury, implant-related complications, and wound infection. Pseudarthroses and adjacent segment pathologies were not included in this review. Adverse events that were not specifically related to spinal surgery and did not affect recovery were also excluded. RESULTS: Perioperative complications occurred in 9% of patients (11/124); including three cases of temporary postoperative neuralgia, two deep wound infections, two pedicle screw misplacements, two cage migrations, one dural tear, and one grafted bone extrusion. No neurologic deficits were reported. Eight complications occurred in the first one-third of the series and only 3 complications occurred in the last two-thirds of the series. Additional surgeries were performed in 6% of patients (7/124); including four reoperations (two for cage migrations, one for a misplaced screw, and one for an extruded graft bone fragment) and three hardware removals (one for a misplaced screw and two for infected cages). CONCLUSIONS: We found perioperative complications occurred more often in the early period of a surgeon's experience with minimally invasive TLIF. Implant-related complications were common and successfully managed by additional surgeries in this series. We suggest greater caution should be exercised to avoid the potential complications, especially when surgeon is a novice to this procedure. The Korean Orthopaedic Association 2015-03 2015-02-10 /pmc/articles/PMC4329539/ /pubmed/25729524 http://dx.doi.org/10.4055/cios.2015.7.1.91 Text en Copyright © 2015 by The Korean Orthopaedic Association http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Park, Yung
Lee, Soo Bin
Seok, Sang Ok
Jo, Byung Woo
Ha, Joong Won
Perioperative Surgical Complications and Learning Curve Associated with Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Single-Institute Experience
title Perioperative Surgical Complications and Learning Curve Associated with Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Single-Institute Experience
title_full Perioperative Surgical Complications and Learning Curve Associated with Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Single-Institute Experience
title_fullStr Perioperative Surgical Complications and Learning Curve Associated with Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Single-Institute Experience
title_full_unstemmed Perioperative Surgical Complications and Learning Curve Associated with Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Single-Institute Experience
title_short Perioperative Surgical Complications and Learning Curve Associated with Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Single-Institute Experience
title_sort perioperative surgical complications and learning curve associated with minimally invasive transforaminal lumbar interbody fusion: a single-institute experience
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4329539/
https://www.ncbi.nlm.nih.gov/pubmed/25729524
http://dx.doi.org/10.4055/cios.2015.7.1.91
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