Long-term complications of minimally-open anterolateral interbody fusion for L5-S1.


Journal

Neuro-Chirurgie
ISSN: 1773-0619
Titre abrégé: Neurochirurgie
Pays: France
ID NLM: 0401057

Informations de publication

Date de publication:
Apr 2020
Historique:
received: 27 05 2019
revised: 14 11 2019
accepted: 11 12 2019
pubmed: 22 3 2020
medline: 11 11 2020
entrez: 22 3 2020
Statut: ppublish

Résumé

Multiple surgical techniques and approaches exist to obtain lumbar interbody fusion. Anterolateral (oblique) is a relatively recent technique. Controversy exists for its use at the L5-S1 level. We performed this study in order to show the safety and efficacy of this technique. The aim of this study was to report the long-term complications and fusion rates of minimally-open (mini-open) anterolateral interbody fusion at the L5-S1 level. We retrospectively analyzed all patients who underwent mini-open anterolateral interbody fusion for L5-S1 level in our department. The data collected were the following: age, sex, surgical indication, acute (less than four weeks) and long-term complications (>3 months), fusion at six months and length of follow-up. Seventeen patients (8M/9F) underwent mini-open anterolateral interbody fusion at L5-S1. The mean age was 64.5 years. The surgical indication was scoliosis in 10 cases, flat back in 4 cases, and spondylolisthesis in 3 cases. All patients underwent a complementary posterior procedure that included fixation. Mean blood loss was 252.9mL for the anterior procedure. Eight acute and minor complications occurred (anemia, delirium, and psoas paresis). Two acute complications required surgical intervention (cage displacement and hematoma). Long-term complications were observed in 2 cases and included proximal junction kyphosis and non-union. The fusion rate was evaluated at 88%. The mean follow-up period was 28.3 months. Mini-open anterolateral interbody fusion at the L5-S1 level is safe and results in fusion at the same rate as anterior interbody fusion. Most acute complications are minor and resolve spontaneously.

Sections du résumé

BACKGROUND BACKGROUND
Multiple surgical techniques and approaches exist to obtain lumbar interbody fusion. Anterolateral (oblique) is a relatively recent technique. Controversy exists for its use at the L5-S1 level. We performed this study in order to show the safety and efficacy of this technique. The aim of this study was to report the long-term complications and fusion rates of minimally-open (mini-open) anterolateral interbody fusion at the L5-S1 level.
METHODS METHODS
We retrospectively analyzed all patients who underwent mini-open anterolateral interbody fusion for L5-S1 level in our department. The data collected were the following: age, sex, surgical indication, acute (less than four weeks) and long-term complications (>3 months), fusion at six months and length of follow-up.
RESULTS RESULTS
Seventeen patients (8M/9F) underwent mini-open anterolateral interbody fusion at L5-S1. The mean age was 64.5 years. The surgical indication was scoliosis in 10 cases, flat back in 4 cases, and spondylolisthesis in 3 cases. All patients underwent a complementary posterior procedure that included fixation. Mean blood loss was 252.9mL for the anterior procedure. Eight acute and minor complications occurred (anemia, delirium, and psoas paresis). Two acute complications required surgical intervention (cage displacement and hematoma). Long-term complications were observed in 2 cases and included proximal junction kyphosis and non-union. The fusion rate was evaluated at 88%. The mean follow-up period was 28.3 months.
CONCLUSIONS CONCLUSIONS
Mini-open anterolateral interbody fusion at the L5-S1 level is safe and results in fusion at the same rate as anterior interbody fusion. Most acute complications are minor and resolve spontaneously.

Identifiants

pubmed: 32197973
pii: S0028-3770(20)30036-9
doi: 10.1016/j.neuchi.2019.12.010
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

85-90

Informations de copyright

Copyright © 2020 Elsevier Masson SAS. All rights reserved.

Auteurs

F Abed Rabbo (F)

Service de neurochirurgie B, centre hospitalo-universitaire (CHU) de Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont-Ferrand, France. Electronic address: francis.ar@gmail.com.

Z Wang (Z)

Service d'orthopédie, centre hospitalier de l'université de Montréal (CHUM), 100, rue Saint-Denis, bureau E-368, 3(e) étage, QC H2X 0C1 Montréal, Canada.

T Sunna (T)

Division of neurosurgery, American University of Beirut Medical Center, P.O.Box: 11-0236 Riad El Solh Beirut, 1107 2020 Beirut, Lebanon.

N Newman (N)

Service d'orthopédie, centre hospitalier de l'université de Montréal (CHUM), 100, rue Saint-Denis, bureau E-368, 3(e) étage, QC H2X 0C1 Montréal, Canada.

F Zairi (F)

Service de neurochirurgie, Ramsay général de santé, hôpital privé Le Bois, 59000 Lille, France.

G Boubez (G)

Service d'orthopédie, centre hospitalier de l'université de Montréal (CHUM), 100, rue Saint-Denis, bureau E-368, 3(e) étage, QC H2X 0C1 Montréal, Canada.

D Shedid (D)

Service de neurochirurgie, centre hospitalier de l'université de Montréal (CHUM), 1000, rue Saint-Denis, bureau E-368, 3(e) étage, QC H2X 0C1 Montréal, Canada.

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