Surgical complications of posterior lumbar interbody fusion with total facetectomy in 251 patients
- 1 April 2006
- journal article
- Published by Journal of Neurosurgery Publishing Group (JNSPG) in Journal of Neurosurgery: Spine
- Vol. 4 (4), 304-309
- https://doi.org/10.3171/spi.2006.4.4.304
Abstract
Previous studies of surgical complications associated with posterior lumbar interbody fusion (PLIF) are of limited value due to intrastudy variation in instrumentation and fusion techniques. The purpose of the present study was to examine rates of intraoperative and postoperative complications of PLIF using a large number of cases with uniform instrumentation and a uniform fusion technique. The authors reviewed the hospital records of 251 patients who underwent PLIF for degenerative lumbar disorders between 1996 and 2002 and who could be followed for at least 2 years. Intraoperative, early postoperative, and late postoperative complications were investigated. Intraoperative complications occurred in 26 patients: dural tearing in 19 patients and pedicle screw malposition in seven patients. Intraoperative complications did not affect the postoperative clinical results. Early postoperative complications occurred in 19 patients: brain infarction occurred in one, infection in one, and neurological complications in 17. Of the 17 patients with neurological complications, nine showed severe motor loss such as foot drop; the remaining eight patients showed slight motor loss or radicular pain alone, and their symptoms improved within 6 weeks. Late postoperative complications occurred in 17 patients: hardware failure in three, nonunion in three, and adjacent-segment degeneration in 11. Postoperative progression of symptomatic adjacent-segment degeneration was defined as a condition that required additional surgery to treat neurological deterioration. The most serious complications of PLIF were postoperative severe neurological deficits and adjacent-segment degeneration. Prevention and management of such complications are necessary to attain good long-term clinical results.Keywords
This publication has 30 references indexed in Scilit:
- Clinical outcomes and complications associated with pedicle screw fixation—augmented lumbar interbody fusionJournal of Neurosurgery: Spine, 2004
- Posterior Lumbar Interbody Fusion Using Local Facet Joint Autograft and Pedicle Screw FixationSpine, 2004
- Perioperative Complications of Threaded Cylindrical Lumbar Interbody Fusion DevicesJournal of Spinal Disorders & Techniques, 2003
- Complications of pedicle screws in lumbar and lumbosacral fusions in 105 consecutive primary operationsEuropean Spine Journal, 2002
- Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusionEuropean Spine Journal, 2001
- Posterior lumbar interbody fusion combined with instrumented postero-lateral fusion: 5-year results in 60 patientsEuropean Spine Journal, 2000
- Disc degeneration in young patients with isthmic spondylolisthesis treated operatively or conservatively: A long-term follow-upEuropean Spine Journal, 1997
- Posterolateral lumbosacral fusion with transpedicular fixation:63 consecutive cases followed for 4 (2–6) yearsActa Orthopaedica, 1996
- Posterolateral lumbar fusion: Outcome of 71 consecutive operations after 4 (2-7) yearsActa Orthopaedica, 1994
- Practice Variations, Treatment Fads, Rising DisabilitySpine, 1993