"Instrumentation-related complications of lumbar degenerative disc dise" by Xinyu Yang and Xinyu Liu

Article Title

Instrumentation-related complications of lumbar degenerative disc diseases treated by minimally invasive transforaminal lumbar interbody fusion

Authors

Xinyu Yang, Department of Orthopedics, Qilu Hospital of Shandong University, Ji’nan 250012, Shandong, China
Xinyu Liu, Department of Orthopedics, Qilu Hospital of Shandong University, Ji’nan 250012, Shandong, China

Keywords

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

Abstract

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.

DOI

https://doi.org/10.26599/BSA.2019.9050019

Publisher

Tsinghua University Press

Recommended Citation

Xinyu Yang, Xinyu Liu. Instrumentation-related complications of lumbar degenerative disc diseases treated by minimally invasive transforaminal lumbar interbody fusion. Brain Science Advances 2019, 05(03): 213-219.

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