Complications From LLIF Are Similar to Those From Other Spinal Procedures

The complication rate during and following lateral lumbar interbody fusion (LLIF) of the spine is comparable to that of other approaches to corrective spinal surgeries, according to the results of a single institution cohort study.

To determine complication rates in patients who had LLIF as part of staged surgical reconstruction of the spine for adult deformity correction, the researchers retrospectively studied 576 patients who had LLIF from 2016 through 2020.

Following the index LLIF, all participants had supplementary instrument placement via anterior, posterior, or transforaminal LIF.

The study’s primary outcomes were complications found during the initial inpatient hospital stay, categorized as either approach‑related or secondary complications identified during outpatient follow-up. The study also assessed secondary outcomes up to 6 years after surgery.

As a result, the researchers found that the overall complication rate during inpatient treatment was 19.2%. Approach-related complications had occurred in 10.5% (n = 59) of the patients studied. The most common approach-related complications were intraoperative hemorrhage, defined as blood loss of more than 500 mL (average, 659 mL), in 4% (n = 23) of patients and temporary hip-flexor weakness on the ipsilateral side of the procedure after discharge in 2.6% (n = 15) of patients. In addition, 1 patient (0.2%) had experienced permanent femoral nerve damage, 2 (0.4%) experienced a pneumothorax, and 7 (1.2%) had a bowel injury.

Secondary complications had occurred in 8.7% (n = 48) of patients. The most common secondary complication was impaired wound healing in 2.1% (n = 12) of patients. This complication led to wound dehiscence in 0.9% (n = 5) of patients. In addition, 0.5%, (n = 3) of patients had experienced postoperative ileus.

Revision surgery was performed in 7.1% (n = 41) of patients over an average of 372 days (+ 34 d) after the initial LIF. One patient required 3 revisions, 3 patients required 2 revisions, and 37 required one.

“The results indicated that complications rates (19.2%) remained in keeping [with] rates reported by other studies,” the researchers concluded.

—Ellen Kurek

Reference:

Godolias P, Frieler S, Tataryn ZL, et al. Towards a more realistic appraisal of complications following staged lateral lumbar interbody fusion: a single institution series. Global Spine J. Published online April 21, 2022. doi:10.1177/21925682221096621