scholarly journals Accidental Durotomy in Minimally Invasive Transforaminal Lumbar Interbody Fusion: Frequency, Risk Factors, and Management

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Jan-Helge Klingler ◽  
Florian Volz ◽  
Marie T. Krüger ◽  
Evangelos Kogias ◽  
Roland Rölz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Minimally Invasive ◽  
Body Mass ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Invasive Approach ◽  
Increased Risk ◽  
Csf Leakage

Purpose. To assess the frequency, risk factors, and management of accidental durotomy in minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).Methods. This single-center study retrospectively investigates 372 patients who underwent MIS TLIF and were mobilized within 24 hours after surgery. The frequency of accidental durotomies, intraoperative closure technique, body mass index, and history of previous surgery was recorded.Results. We identified 32 accidental durotomies in 514 MIS TLIF levels (6.2%). Analysis showed a statistically significant relation of accidental durotomies to overweight patients (body mass index ≥25 kg/m2;P=0.0493). Patient age older than 65 years tended to be a positive predictor for accidental durotomies (P=0.0657). Mobilizing patients on the first postoperative day, we observed no durotomy-associated complications.Conclusions. The frequency of accidental durotomies in MIS TLIF is low, with overweight being a risk factor for accidental durotomies. The minimally invasive approach seems to minimize durotomy-associated complications (CSF leakage, pseudomeningocele) because of the limited dead space in the soft tissue. Patients with accidental durotomy can usually be mobilized within 24 hours after MIS TLIF without increased risk. The minimally invasive TLIF technique might thus be beneficial in the prevention of postoperative immobilization-associated complications such as venous thromboembolism. This trial is registered withDRKS00006135.

Is Body Mass Index a Risk Factor for Revision Procedures After Minimally Invasive Transforaminal Lumbar Interbody Fusion?

2018 ◽  
Vol 31 (1) ◽  
pp. E85-E91 ◽  
Author(s):  
Ankur S. Narain ◽  
Fady Y. Hijji ◽  
Daniel D. Bohl ◽  
Kelly H. Yom ◽  
Krishna T. Kudaravalli ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Risk Factor ◽  
Minimally Invasive ◽  
Body Mass ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion

scholarly journals Analysis of risk factors for perioperative hidden blood loss in patients undergoing transforaminal lumbar interbody fusion

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052093784
Author(s):  
Rui Zhang ◽  
Fei Xing ◽  
Zhuqing Yang ◽  
Guoxiong Lin ◽  
Jianjun Chu
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Blood Loss ◽  
Body Mass ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Hidden Blood Loss ◽  
Fusion Level ◽  
Independent Risk Factors

Objective This study was performed to analyze the correlation between perioperative hidden blood loss (HBL) and the general condition of patients undergoing transforaminal lumbar interbody fusion (TLIF). Methods We retrospectively analyzed patients who underwent TLIF from July 2017 to July 2019 in our hospital. Sex, age, body mass index, underlying diseases, American Society of Anesthesiologists classification, coagulation function, preoperative and postoperative hemoglobin level and hematocrit, surgery time, fusion level, intraoperative blood loss, and drainage volume were recorded. Postoperative complications were also recorded. The amount of HBL was calculated, and its correlation with related variables was analyzed. Results The mean surgery time was 153.32 ± 54.86 minutes. The total perioperative blood loss was 789.22 ± 499.68 mL, including HBL of 315.69 ± 199.87 mL. Pearson correlation analysis showed statistically significant differences in HBL according to the body mass index, hypertension, fibrinogen, surgery time, and fusion level. Multiple linear regression analysis indicated that the surgery time and fusion level were independent risk factors for HBL. Conclusions A certain amount of HBL occurs in TLIF surgery and cannot be ignored in daily clinical work. The operation time and surgery level are independent risk factors for HBL.

The identification of risk factors for increased postoperative pain following minimally invasive transforaminal lumbar interbody fusion

2020 ◽  
Vol 29 (6) ◽  
pp. 1304-1310
Author(s):  
Nathaniel W. Jenkins ◽  
James M. Parrish ◽  
Benjamin C. Mayo ◽  
Nadia M. Hrynewycz ◽  
Thomas S. Brundage ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Pain ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion

Minimally invasive unilateral approach for bilateral decompression of spinal stenosis and modified transforaminal lumbar interbody fusion for degenerative spondylolisthesis

2013 ◽  
Vol 35 (v2supplement) ◽  
pp. Video4 ◽  
Author(s):  
Kevin S. Chen ◽  
Khoi D. Than ◽  
Frank LaMarca ◽  
Paul Park
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screw ◽  
Spinal Stenosis ◽  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Invasive Approach ◽  
Unilateral Approach ◽  
Percutaneous Pedicle Screw

This video describes a minimally invasive approach for treatment of symptomatic grade I spondylolisthesis and high-grade spinal stenosis. In this procedure, a unilateral approach for bilateral decompression is utilized in conjunction with a modified transforaminal lumbar interbody fusion and percutaneous pedicle screw fixation. The key steps in the procedure are outlined, and include positioning, fluoroscopic positioning/guidance, exposure with tubular retractor system, technique for ipsilateral and contra-lateral decompression, disc space preparation and interbody grafting, percutaneous pedicle screw and rod placement, and closure.The video can be found here: http://youtu.be/QTymO4Cu4B0.

Minimally Invasive Transforaminal Lumbar Interbody Fusion: 2-Dimensional Surgical Video

2019 ◽  
Vol 17 (2) ◽  
pp. E53-E53
Author(s):  
Joseph H McMordie ◽  
Eric X Chen ◽  
Landon D Ehlers ◽  
Christopher C Gillis
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Patient Positioning ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Intraoperative Navigation ◽  
Radiographic Evaluation ◽  
Lumbar Interbody Fusion ◽  
Disc Space ◽  
Invasive Approach ◽  
Percutaneous Pedicle Screw

Abstract This operative video is a detailed look at minimally invasive transforaminal lumbar interbody fusion. We provide a step-by-step guide with appropriate narration and operative video to enhance the educational experience. We review clinical and radiographic evaluation, patient positioning, intraoperative navigation, localization, percutaneous pedicle screw placement, minimally invasive approach, disc space preparation, placement of interbody device, and closure. By presenting up-to-date minimally invasive and intraoperative navigation techniques, this video provides educational benefit to all neurosurgeons regardless of training level.

Risk Factors of Cage Subsidence in Patients Received Minimally Invasive Transforaminal Lumbar Interbody Fusion

Spine ◽  
2020 ◽  
Vol 45 (19) ◽  
pp. E1279-E1285 ◽  
Author(s):  
Yu-Cheng Yao ◽  
Po-Hsin Chou ◽  
Hsi-Hsien Lin ◽  
Shih-Tien Wang ◽  
Chien-Lin Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Cage Subsidence

Incidence of and risk factors for superior facet violation in minimally invasive versus open pedicle screw placement during transforaminal lumbar interbody fusion: a comparative analysis

2013 ◽  
Vol 18 (4) ◽  
pp. 356-361 ◽  
Author(s):  
Darryl Lau ◽  
Samuel W. Terman ◽  
Rakesh Patel ◽  
Frank La Marca ◽  
Paul Park
Keyword(s):  
Risk Factors ◽  
Minimally Invasive ◽  
Pedicle Screw ◽  
Interbody Fusion ◽  
Facet Joint ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Screw Placement ◽  
Lumbar Interbody Fusion ◽  
Pedicle Screw Placement ◽  
Percutaneous Pedicle Screw

Object A reported risk factor for adjacent-segment disease is injury to the superior facet joint from pedicle screw placement. Given that the facet joint is not typically visualized during percutaneous pedicle screw insertion, there is a concern for increased facet violation (FV) in minimally invasive fusion procedures. The purpose of this study was to analyze and compare the incidence of FV among patients undergoing minimally invasive transforaminal lumbar interbody fusion (MITLIF) and open transforaminal lumbar interbody fusion (TLIF). The impact of O-arm navigation compared with traditional fluoroscopy on FV in MITLIF is also assessed, as are risk factors for FV. Methods The authors identified a consecutive population of patients who underwent MITLIF with percutaneous pedicle screw placement, as well as a matched cohort of patients who underwent open TLIF. Postoperative CT imaging was assessed to determine intraarticular FV due to pedicle screw placement. Patients were stratified into minimally invasive and open TLIF groups. Within the MITLIF group, the authors performed a subanalysis of image guidance methods used in cases of FV. Two-tailed Student t-test, ANOVA, chi-square testing, and logistic regression were used for statistical analysis. Results A total of 282 patients were identified, with a total of 564 superior pedicle screw placements. The MITLIF group consisted of 142 patients with 284 screw insertions. The open TLIF group consisted of 140 patients with 280 screw insertions. Overall, 21 (7.4%) of 282 patients experienced FV. A total of 21 screws violated a facet joint for a screw-based FV rate of 3.7% (21 of 564 screws). There were no significant differences between the MITLIF and open TLIF groups in the percentage of patients with FV (6.3% vs 8.6%) and or the percentage of screws with FV (3.2% vs 4.3%) (p = 0.475 and p = 0.484, respectively). Further stratifying the MI group into O-arm navigation and fluoroscopic guidance subgroups, the patient-based rates of FV were 10.8% (4 of 37 patients) and 4.8% (5 of 105 patients), respectively, and the screw-based rates of FV were 5.4% (4 of 74 screws) and 2.4% (5 of 210 screws), respectively. There was no significant difference between the subgroups with respect to patient-based or screw-based FV rates (p = 0.375 and p = 0.442, respectively). The O-arm group had a significantly higher body mass index (BMI) (p = 0.021). BMI greater than 29.9 was independently associated with higher FV (OR 2.36, 95% CI 1.65–8.53, p = 0.039). Conclusions The findings suggest that minimally invasive pedicle screw placement is not associated with higher rates of FV. Overall violation rates were similar in MITLIF and open TLIF. Higher BMI, however, was a risk factor for increased FV. The use of O-arm fluoroscopy with computer-assisted guidance did not significantly decrease the rate of FV.

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