Brain Science Advances


lumbar, degenerative diseases, minimally invasive surgery, transforaminal lumbar interbody fusion, instrumentation, complication


Objective:To analyze the instrumentation-related complications of patients with lumbar degenerative disc diseases (LDD) who underwent minimally invasive transforaminal lumbar interbody fusion (MIS- TLIF) and to discuss the potential strategy for the control of these complications.Methods:A total of 87 patients with LDD were treated with the MIS-TLIF procedure. Complications, including malposition or breakage of guide pin, percutaneous pedicle screw (PPS) or cages, neurological deficit, and superior-level facet joint violations, were determined during and after the surgery. Computed tomography (CT) was used to evaluate the PPS accuracy and the superior-level facet joint violations.Results:A total of 386 PPSs were used. During the surgery, 3 (0.8%) guide pin and 1 (0.3%) PPS perforated the anterior wall of the vertebral body, respectively. One (0.3%) PPS was pulled out during the reduction of slip. Malposition of the cages occurred in 6 (1.6%) PPSs. These were all adjusted accordingly during the surgery. All the patients received > 2 years of follow-up. No loosening or breakage of PPS and cage was observed, but CT showed 27 (7.0%) PPSs misplaced. No neurological deficit related to misplaced PPS was observed. The total facet joint violation (FJV) rate was 36.2%, with grade 2 and grade 3 violations is 21 (12.1%) and 6 (3.4%), respectively.Conclusion:MIS-TLIF has similar instrumentation-related complications with open TLIF. Accurate preoperative evaluation and improved surgical techniques can effectively reduce these instrumentation-related complications.


Tsinghua University Press