scholarly journals Risk Factors for Posterior Cage Migration after Lumbar Interbody Fusion Surgery

2018 ◽  
Vol 12 (1) ◽  
pp. 59-68 ◽  
Author(s):  
Dong-Yeong Lee ◽  
Young-Jin Park ◽  
Sang-Youn Song ◽  
Soon-Taek Jeong ◽  
Dong-Hee Kim
Keyword(s):  
Risk Factors ◽  
Interbody Fusion ◽  
Multiple Logistic Regression Analysis ◽  
Univariate Analysis ◽  
Surgical Techniques ◽  
Case Series ◽  
Posterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Related Factors ◽  
Low Bmi

<sec><title>Study Design</title><p>A retrospective clinical case series.</p></sec><sec><title>Purpose</title><p>To determine the strength of association between cage retropulsion and its related factors.</p></sec><sec><title>Overview of Literature</title><p>Lumbar interbody fusion with cage can obtain a firm union and can restore the disc height with normal sagittal and coronal alignment. Although lumbar interbody fusion procedures have satisfactory clinical outcomes, peri- and postoperative complications regarding the cage remain challenging.</p></sec><sec><title>Methods</title><p>From January 2006 to June 2016, 1,047 patients with lumbar degenerative disc disease who underwent posterior lumbar interbody fusion or transforaminal interbody fusion at Gyeongsang National University Hospital were enrolled. Medical records and pre- and postoperative radiographs were reviewed to identify significant cage retropulsion-related factors. The associations between cage retropulsion with various risk factors were evaluated by calculating odds ratios (ORs) and 95% confidence intervals (CIs) using multiple logistic regression analysis.</p></sec><sec><title>Results</title><p>Of 1,229 disc levels, 16 cases (1.3%, 10 men and 6 women) had cage retropulsion. Univariate analysis revealed no significant differences between the cage retropulsion group and the no cage retropulsion group with regard to demographic data such as age, sex, weight, height, body mass index (BMI), smoking habits, presence of osteoporosis, and duration of follow-up. Multivariate analysis revealed that low BMI (OR, 0.875; 95% CI, 0.771–0.994; <italic>p</italic>=0.040), presence of screw loosening (OR, 27.400; 95% CI, 7.818–96.033; <italic>p</italic>&lt;0.001), and pear-shaped disc (OR, 9.158; 95% CI, 2.455–34.160; <italic>p</italic>=0.001) were significantly associated with cage retropulsion.</p></sec><sec><title>Conclusions</title><p>This study demonstrated that low BMI, loosening of posterior instrumentation, and pear-shaped disc were associated with cage retropulsion after lumbar interbody fusion. Therefore, when performing lumbar interbody fusion with a cage, surgeons should have skillful surgical techniques for firm fixation to prevent cage retropulsion, particularly in non-obese patients.</p></sec>

Risk Factors for Poor Patient-Reported Quality of Life Outcomes After Posterior Lumbar Interbody Fusion

Spine ◽  
2017 ◽  
Vol 42 (19) ◽  
pp. 1502-1510 ◽  
Author(s):  
Takahiro Makino ◽  
Takashi Kaito ◽  
Hiroyasu Fujiwara ◽  
Hirotsugu Honda ◽  
Yusuke Sakai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Life Outcomes ◽  
Poor Patient ◽  
Quality Of Life Outcomes ◽  
Patient Reported

scholarly journals High-dose tranexamic acid reduces intraoperative and postoperative blood loss in posterior lumbar interbody fusion

2017 ◽  
Vol 26 (3) ◽  
pp. 363-367 ◽  
Author(s):  
Junichi Kushioka ◽  
Tomoya Yamashita ◽  
Shinya Okuda ◽  
Takafumi Maeno ◽  
Tomiya Matsumoto ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Interbody Fusion ◽  
Surgical Techniques ◽  
Posterior Lumbar Interbody Fusion ◽  
Postoperative Blood Loss ◽  
Control Group ◽  
High Dose ◽  
Lumbar Interbody Fusion ◽  
Single Level

OBJECTIVE Tranexamic acid (TXA), a synthetic antifibrinolytic drug, has been reported to reduce blood loss in orthopedic surgery, but there have been few reports of its use in spine surgery. Previous studies included limitations in terms of different TXA dose regimens, different levels and numbers of fused segments, and different surgical techniques. Therefore, the authors decided to strictly limit TXA dose regimens, surgical techniques, and fused segments in this study. There have been no reports of using TXA for prevention of intraoperative and postoperative blood loss in posterior lumbar interbody fusion (PLIF). The purpose of the study was to evaluate the efficacy of high-dose TXA in reducing blood loss and its safety during single-level PLIF. METHODS The study was a nonrandomized, case-controlled trial. Sixty consecutive patients underwent single-level PLIF at a single institution. The first 30 patients did not receive TXA. The next 30 patients received 2000 mg of intravenous TXA 15 minutes before the skin incision was performed and received the same dose again 16 hours after the surgery. Intra- and postoperative blood loss was compared between the groups. RESULTS There were no statistically significant differences in preoperative parameters of age, sex, body mass index, preoperative diagnosis, or operating time. The TXA group experienced significantly less intraoperative blood loss (mean 253 ml) compared with the control group (mean 415 ml; p < 0.01). The TXA group also had significantly less postoperative blood loss over 40 hours (mean 321 ml) compared with the control group (mean 668 ml; p < 0.01). Total blood loss in the TXA group (mean 574 ml) was significantly lower than in the control group (mean 1080 ml; p < 0.01). From 2 hours to 40 hours, postoperative blood loss in the TXA group was consistently significantly lower. There were no perioperative complications, including thromboembolic events. CONCLUSIONS High-dose TXA significantly reduced both intra- and postoperative blood loss without causing any complications during or after single-level PLIF.

scholarly journals Comparison of Opioid Consumption Patterns of Three Interbody Fusion Surgical Techniques

2021 ◽  
pp. 219256822110677
Author(s):  
Taryn E. LeRoy ◽  
Andrew Moon ◽  
Matthew Chilton ◽  
Marissa Gedman ◽  
Jessica P. Aidlen ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Surgical Techniques ◽  
Posterior Lumbar Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Opioid Consumption ◽  
Lumbar Interbody Fusion ◽  
Opioid Use ◽  
Invasive Approach ◽  
Cortical Screw ◽  
Chi Square Analysis

Study Design Retrospective review. Objectives With increased awareness of the opioid crisis in spine surgery, the focus postoperatively has shifted to managing surgical site pain while minimizing opioid use. Numerous studies have compared outcomes and fusion status of different interbody fusion techniques; however, there is limited literature evaluating opioid consumption postoperatively between techniques. The aim of this study was to assess in-house and postoperative opioid consumption across 3 surgical techniques. Methods Patients were stratified by technique: posterior lumbar interbody fusion (PLIF), minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), and cortical screw (CS) instrumentation with interbody fusion. Age, ASA, BMI, depression, preoperative opioid use, EBL, and OR time were recorded and compared across surgical groups using Welch’s ANOVA and chi-square analysis. Total morphine equivalent dose (MED) was tabulated for both in-house consumption and postoperative prescriptions and was compared across surgical techniques using Welch’s ANOVA analysis, Mann Whitney U tests, and linear regression. Results Two hundred and thirty nine patients underwent one- or two-level posterior lumbar interbody fusion between 2016 and 2020. One hundred and twenty one patients underwent CS instrumentation, 95 underwent PLIF, and 83 underwent MIS-TLIF. There was a significantly higher percentage of patients who had a history of depression and preoperative opioid consumption in the CS group ( P = .001, P = .009). CS instrumentation required significantly less total post-op opioids per kilogram bodyweight compared to MIS-TLIF and PLIF surgeries ( P = .029). Conclusions Patients who underwent CS instrumentation required less opioids postoperatively. CS instrumentation may be associated with less postoperative pain due to the less invasive approach, however, patient education and prescriber practice also play a role in postoperative opioid consumption.

Sign in / Sign up

Export Citation Format

Share Document