TY - JOUR
T1 - Complication Risk in Primary and Revision Minimally Invasive Lumbar Interbody Fusion
T2 - A Comparable Alternative to Conventional Open Techniques?
AU - Bortz, Cole
AU - Alas, Haddy
AU - Segreto, Frank
AU - Horn, Samantha R.
AU - Varlotta, Christopher
AU - Brown, Avery E.
AU - Pierce, Katherine E.
AU - Ge, David H.
AU - Vasquez-Montes, Dennis
AU - Lafage, Virginie
AU - Lafage, Renaud
AU - Fischer, Charla R.
AU - Gerling, Michael C.
AU - Protopsaltis, Themistocles S.
AU - Buckland, Aaron J.
AU - Sciubba, Daniel M.
AU - De La Garza-Ramos, Rafael
AU - Passias, Peter G.
N1 - Publisher Copyright:
© The Author(s) 2019.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Study Design: Retrospective cohort study of prospective patients undergoing minimally invasive lumbar fusion at a single academic institution. Objective: To assess differences in perioperative outcomes between primary and revision MIS (minimally invasive surgical) lumbar interbody fusion patients and compare with those undergoing corresponding open procedures. Methods: Patients ≥18 years old undergoing lumbar interbody fusion were grouped by surgical technique: MIS or open. Patients within each group were propensity score matched for comorbidities and levels fused. Patient demographics, surgical factors, and perioperative complication incidences were compared between primary and revision cases using means comparison tests, as appropriate. Results: Of the 214 lumbar interbody fusion patients included after propensity score matching, 44 (21%) cases were MIS, and 170 (79%) were open. For MIS patients, there were no significant differences between primary and revision cases in estimated blood loss (EBL; 344 vs 299 cm3, P =.682); however, primary cases had longer operative times (301 vs 246 minutes, P =.029). There were no differences in length of stay (LOS), intensive care unit LOS, readmission, and intraoperative or postoperative complications (all P >.05). For open patients, there were no differences between primary and revision cases in EBL (P >.05), although revisions had longer operative times (331 vs 278 minutes, P =.018) and more postoperative complications (61.7% vs 23.8%, P <.001). MIS revision procedures were shorter than open revisions (182 vs 213 minutes, P =.197) with significantly less EBL (294 vs 965 cm3, P <.001), shorter inpatient and intensive care unit LOS, and fewer postoperative complications (all P <.05). Conclusions: Clinical outcomes of revision MIS lumbar interbody fusion were similar to those of primary surgery. Additionally, MIS techniques were associated with less EBL, shorter LOS, and fewer perioperative complications than corresponding open revisions.
AB - Study Design: Retrospective cohort study of prospective patients undergoing minimally invasive lumbar fusion at a single academic institution. Objective: To assess differences in perioperative outcomes between primary and revision MIS (minimally invasive surgical) lumbar interbody fusion patients and compare with those undergoing corresponding open procedures. Methods: Patients ≥18 years old undergoing lumbar interbody fusion were grouped by surgical technique: MIS or open. Patients within each group were propensity score matched for comorbidities and levels fused. Patient demographics, surgical factors, and perioperative complication incidences were compared between primary and revision cases using means comparison tests, as appropriate. Results: Of the 214 lumbar interbody fusion patients included after propensity score matching, 44 (21%) cases were MIS, and 170 (79%) were open. For MIS patients, there were no significant differences between primary and revision cases in estimated blood loss (EBL; 344 vs 299 cm3, P =.682); however, primary cases had longer operative times (301 vs 246 minutes, P =.029). There were no differences in length of stay (LOS), intensive care unit LOS, readmission, and intraoperative or postoperative complications (all P >.05). For open patients, there were no differences between primary and revision cases in EBL (P >.05), although revisions had longer operative times (331 vs 278 minutes, P =.018) and more postoperative complications (61.7% vs 23.8%, P <.001). MIS revision procedures were shorter than open revisions (182 vs 213 minutes, P =.197) with significantly less EBL (294 vs 965 cm3, P <.001), shorter inpatient and intensive care unit LOS, and fewer postoperative complications (all P <.05). Conclusions: Clinical outcomes of revision MIS lumbar interbody fusion were similar to those of primary surgery. Additionally, MIS techniques were associated with less EBL, shorter LOS, and fewer perioperative complications than corresponding open revisions.
KW - comorbidity
KW - length of stay
KW - lumbosacral region
KW - minimally invasive surgical procedures
KW - operative time
KW - patient readmission
KW - postoperative complications
KW - retrospective studies
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U2 - 10.1177/2192568219867289
DO - 10.1177/2192568219867289
M3 - Article
C2 - 32677572
AN - SCOPUS:85087150334
SN - 2192-5682
VL - 10
SP - 619
EP - 626
JO - Global Spine Journal
JF - Global Spine Journal
IS - 5
ER -