scholarly journals Psoas hematoma as a rare complication of posterior lumbar interbody fusion: a case report

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bo Deng ◽  
Hai Nan Hong ◽  
Xin Bing Feng ◽  
Zheng Hua Hong ◽  
Guo Ping Cai ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Lower Limb ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Psoas Muscle ◽  
Lumbar Interbody Fusion ◽  
Segmental Artery ◽  
Post Surgery ◽  
Lower Limb Pain ◽  
The Right

Abstract Background Psoas hematoma rarely occurs in patients with spondylolisthesis who undergo posterior lumbar interbody fusion (PLIF) surgery. Case presentation Here we reported a case of a 57-year-old male patient diagnosed with spondylolisthesis who underwent PLIF at the local hospital. Seven days post-surgery, abdominal pain occurred, and the pain in the right lower limb gradually increased. The computerized tomography (CT) indicated a formation of hematoma around the psoas muscle. Digital-subtraction angiography (DSA) suggested a vascular injury, a rupture of the right segmental artery of the lumbar vertebral level 4. The patient then received DSA vascular embolization, after which the lower lumbar segmental artery active bleeding was stopped. One month after discharge, the abdominal hematoma was gradually absorbed, and the pain in the waist, leg, and abdomen disappeared. Conclusion Symptoms such as abdominal pain, abdominal distension, and exacerbation of lower limb pain, may suggest the occurrence of psoas hematoma after PLIF. DSA vascular embolization is suggested as the first treatment approach for this type of complication.

A Compaction Bone Grafting Technique Leads to Early Bone Fusion in Cases of Posterior Lumbar Interbody Fusion

2015 ◽  
Vol 12 (1) ◽  
pp. 31-38
Author(s):  
Mikinobu Takeuchi ◽  
Norimitsu Wakao ◽  
Mitsuhiro Kamiya ◽  
Atsuhiko Hirasawa ◽  
Shuntaro Hanamura ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Psoas Muscle ◽  
Lumbar Interbody Fusion ◽  
Impaction Bone Grafting ◽  
Computed Tomographic ◽  
Bone Fusion ◽  
Grafting Technique

Abstract BACKGROUND The impaction bone grafting technique is a popular approach for achieving complete bone fusion during hip surgery or total knee arthroplasty. We hypothesized that compaction bone grafting (CBG), a modified version of impaction bone grafting, could be applied to lumbar fusion surgery. OBJECTIVE To compare the bone fusion rates and durations achieved using the CBG technique and a conventional loose bone grafting technique. METHODS We retrospectively reviewed 89 patients who underwent single-level posterior lumbar interbody fusion at the university hospital; 35 other posterior lumbar interbody fusion recipients were excluded due to undergoing multilevel fusion, prior lumbar surgery, trauma, infection, or inadequate computed tomographic data. Computed tomographic-based bone fusion assessments were obtained using the Brantigan, Steffee, and Fraser criteria at 1 and 2 years after surgery. RESULTS The baseline characteristics of the CBG (n = 42) and loose bone grafting (n = 47) groups did not significantly differ. Fusion assessments indicated that significantly superior bone fusion rates were achieved at 1 year after surgery in the CBG group than in the loose bone grafting group (P = .04, χ2 test). However, the bone fusion rates of the 2 groups at 2 years after surgery did not significantly differ (P = .3). A nonsymptomatic surgical complication occurred in the CBG group when a spacer was inserted into the intervertebral space; specifically, the spacer slipped out of the right psoas muscle because a large quantity of compaction bone grafts disrupted the cage's pathway. CONCLUSION In posterior lumbar interbody fusion surgeries, bone fusion was achieved more quickly with the CBG technique than with the conventional technique.

Posterior Lumbar Interbody Fusion with Preservation of Posterior Structures for Management of Lumbar Spondylolisthesis

2021 ◽  
pp. 8
Author(s):  
Tarek Aly
Keyword(s):  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Posterior Lumbar Interbody Fusion ◽  
Anatomic Reconstruction ◽  
Lumbar Interbody Fusion ◽  
Canal Stenosis ◽  
Post Surgery ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis ◽  
Posterior Elements

Introduction: Successful posterior lumbar interbody fusion requires excessive removal of posterior spinal elements and distraction of neural structures. It also requires a large amount of bone graft. The authors have developed this technique to assess results of treatment of degenerative spondylolisthesis by posterior lumbar interbody fusion with preservation of posterior spinal elements and also to examine the safety and efficacy of the recapping  T-saw laminoplasty technique for the management of degenerative lumbar spondylolisthesis using posterior lumbar interbody fusion by interbody cages with preservation of posterior elements. Methodology: Twenty-five patients with degenerative spondylolisthesis underwent recapping T-saw laminoplasty in the lumbar spine for posterior lumbar interbody fusion with interbody cage. The T-saw was used for the division of the posterior elements. After discectomy and insertion of cages, the excised lamina was replaced exactly in situ to their original anatomic position. Patients were followed neurologically and radiologically. Result: Only one lamina was excised and replaced again. Primary bone healing was obtained in all patients by four to six months post surgery. No complications such as postoperative spinal canal stenosis, facet arthrosis, or kyphosis were observed. Conclusion: This technique of posterior lumbar interbody fusion through recapping laminoplasty provide wide space for easier insertion of cages and allow anatomic reconstruction of the vertebral arch preserving its important mechanical roles.

scholarly journals Lateral lumbar interbody fusion (LLIF): Technique and outcomes

2019 ◽  
Vol 1 (1) ◽  
pp. 1-7
Author(s):  
Chester E. Sutterlin ◽  
Jane E. Luscombe ◽  
Jerry Day ◽  
Arvind Dubey
Keyword(s):  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Psoas Muscle ◽  
Surface Characteristics ◽  
Bone Graft Substitute ◽  
Lumbar Interbody Fusion ◽  
Titanium Cage ◽  
Lateral Lumbar Interbody Fusion ◽  
Minimally Invasive Surgical ◽  
3D Printed

Introduction: Historically, an interbody device (IBD) has consisted of morselized autograft1, structural autograft, structural allograft, stainless steel ball, threaded titanium cage, polyetheretherketone (PEEK) cage, and more recently 3D printed titanium cage with bioactive surface characteristics and bony ingrowth into IBD interstices. These IBD’s have been inserted through a variety of approaches, both by open technique and by minimally invasive surgical (MIS) technique. Traditionally, the most common procedures have been posterior lumbar interbody fusion (PLIF), transfacetal lumbar interbody fusion (TLIF), and anterior lumbar interbody fusion (ALIF). Obviously, both PLIF and TLIF are posterior approaches, and ALIF is an anterior approach. More recent approaches in the retroperitoneal space anteriorly are oblique lumbar interbody fusion (OLIF) anterior to the psoas muscle, and lateral lumbar interbody fusion (LLIF) which is a transpsoas procedure. LLIF is the subject of this manuscript. The LLIF technique utilizing K2M’s Ravine retractor system and K2M’s lateral IBD’s, Aleutian (PEEK) and Cascadia (3D printed titanium) will be described (K2M, Leesburg, VA USA). Bone graft substitute, iFactor (Cerapedics, Colorado USA), was used in all cases. No autograft was harvested from the iliac crest, but local morselized autograft was utilized if available. The clinical outcomes for LLIF using these implants and instruments will be reported.

scholarly journals Posterolateral Fusion Versus Posterior Lumbar Interbody Fusion: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
pp. 219256822110164
Author(s):  
Elsayed Said ◽  
Mohamed E. Abdel-Wanis ◽  
Mohamed Ameen ◽  
Ali A. Sayed ◽  
Khaled H. Mosallam ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Loss ◽  
Interbody Fusion ◽  
Revision Rate ◽  
Meta Analysis ◽  
Posterior Lumbar Interbody Fusion ◽  
Operation Time ◽  
Controlled Trials ◽  
Lumbar Interbody Fusion ◽  
Randomized Controlled

Study Design: Systematic review and meta-analysis. Objectives: Arthrodesis has been a valid treatment option for spinal diseases, including spondylolisthesis and lumbar spinal stenosis. Posterolateral and posterior lumbar interbody fusion are amongst the most used fusion techniques. Previous reports comparing both methods have been contradictory. Thus, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to establish substantial evidence on which fusion method would achieve better outcomes. Methods: Major databases including PubMed, Embase, Web of Science and CENTRAL were searched to identify studies comparing outcomes of interest between posterolateral fusion (PLF) and posterior lumbar interbody fusion (PLIF). We extracted data on clinical outcome, complication rate, revision rate, fusion rate, operation time, and blood loss. We calculated the mean differences (MDs) for continuous data with 95% confidence intervals (CIs) for each outcome and the odds ratio with 95% confidence intervals (CIs) for binary outcomes. P < 0.05 was considered significant. Results: We retrieved 8 studies meeting our inclusion criteria, with a total of 616 patients (308 PLF, 308 PLIF). The results of our analysis revealed that patients who underwent PLIF had significantly higher fusion rates. No statistically significant difference was identified in terms of clinical outcomes, complication rates, revision rates, operation time or blood loss. Conclusions: This systematic review and meta-analysis provide a comparison between PLF and PLIF based on RCTs. Although PLIF had higher fusion rates, both fusion methods achieve similar clinical outcomes with equal complication rate, revision rate, operation time and blood loss at 1-year minimum follow-up.

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