Intraoperative and early XXXX in extreme lateral interbody fusion: an analysis of 600 cases.

@entity1 @entity16 @entity260 @entity281 @entity51 @entity1317 @entity130
STUDY DESIGN: Prospective analysis of 600 extreme lateral interbody fusion (XLIF) approach procedures for intraoperative and perioperative complications. OBJECTIVE: To delineate and describe complications in a large, prospective series of minimally invasive lateral lumbar fusion procedures (XLIF). SUMMARY OF BACKGROUND DATA: While some small series of lateral lumbar fusion have discussed complications, no results from large studies have been reported. METHODS: A total of 600 @entity1 were treated with a lateral approach to fusion (XLIF) for degenerative spinal conditions. Data were collected prospectively on all @entity1 and analyzed for demographic, diagnostic, and hospitalization information to identify operative and early @entity260 . Documented complication types and rates in this large series were compared with smaller prior reports on lateral approach fusions, as well as other minimally invasive (mini-anterior lumbar interbody fusion and minimally invasive surgical [MIS] transforaminal lumbar interbody fusion) and more traditional fusion approaches (posterior intertransverse fusion, anterior lumbar interbody fusion, posterior lumbar interbody fusion, transforaminal lumbar interbody fusion). RESULTS: Seven hundred forty-one levels were treated, 80.8% single level, 15.0% 2 level, 4.0% 3 level, 0.2% 4 level; 59.3%, including the L4 to L5 levels. A total of 99.2% included supplemental internal fixation; 83.2% included pedicle screw fixation (predominantly unilateral). Hemoglobin change from pre- to postoperation averaged 1.38. Hospital stay averaged 1.21 days. The overall incidence of perioperative complications (intraoperation and out to 6 weeks postoperation) was 6.2%: 9 (1.5%) in-hospital surgery-related events, 17 (2.8%) in-hospital medical events, 6 (1.0%) out-of-hospital surgery-related events, and 5 (0.8%) out-of-hospital medical events. There were no wound @entity281 , no @entity1317 , no intraoperative @entity130 , and 4 (0.7%) transient @entity51 . Eleven events (1.8%) resulted in additional procedures/reoperation. CONCLUSIONS: Compared with traditional open approaches, the MIS lateral approach to fusion by using the XLIF technique resulted in a lower incidence of @entity16 , and transfusion as well as markedly shorter hospitalization. Complications in MIS XLIF compare favorably with those from other MIS fusion procedures; duration of hospitalization is shorter than with any previously reported technique.
