Complications of the Prone Transpsoas Lateral Lumbar Interbody Fusion for Degenerative Lumbar Spine Disease: A Multicenter Study

Authors

Mohamed A. Soliman, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA.
Luis Diaz-Aguilar, Department of Neurological Surgery, University of California, San Diego, La Jolla, California, USA.
Cathleen C. Kuo, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA.
Alexander O. Aguirre, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA.
Asham Khan, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA.
Jose E. San Miguel-Ruiz, Department of Neurological Surgery, Duke University, Durham, North Carolina, USA.
Rodrigo Amaral, Department of Neurological Surgery, Instituto de Patologia da Coluna, São Palo Sul, Brazil.
Muhammad M. Abd-El-Barr, Department of Neurological Surgery, Duke University, Durham, North Carolina, USA.
Isaac L. Moss, Department of Orthopedic Surgery, University of Connecticut, Farmington, Connecticut, USA.
Tyler Smith, Sierra Spine Institute, Roseville, California, USA.
Gurvinder S. Deol, Wake Orthopaedics, WakeMed Health and Hospitals, Raleigh, North Carolina, USA.
Jeff Ehresman, Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Madison Battista, Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Bryan S. Lee, Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
M Craig McMains, McMains Spine, Indianapolis, Indiana, USA.
Samuel A. Joseph, Joseph Spine Institute, Tampa, Florida, USA.
David Schwartz, OrthoIndy, Indianapolis, Indiana, USA.
Andrew D. Nguyen, Department of Neurological Surgery, University of California, San Diego, La Jolla, California, USA.
William R. Taylor, Department of Neurological Surgery, University of California, San Diego, La Jolla, California, USA.
Luiz Pimenta, Department of Neurological Surgery, Instituto de Patologia da Coluna, São Palo Sul, Brazil.
John Pollina, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA.

Document Type

Article

Abstract

BACKGROUND AND OBJECTIVES: The prone transpsoas (PTP) approach for lateral lumbar interbody fusion (LLIF) is a novel technique for degenerative lumbar spine disease. However, there is a paucity of information in the literature on the complications of this procedure, with all published data consisting of small samples. We aimed to report the intraoperative and postoperative complications of PTP in the largest study to date. METHODS: A retrospective electronic medical record review was conducted at 11 centers to identify consecutive patients who underwent LLIF through the PTP approach between January 1, 2021, and December 31, 2021. The following data were collected: intraoperative characteristics (operative time, estimated blood loss [EBL], intraoperative complications [anterior longitudinal ligament (ALL) rupture, cage subsidence, vascular and visceral injuries]), postoperative complications, and hospital stay. RESULTS: A total of 365 patients were included in the study. Among these patients, 2.2% had ALL rupture, 0.3% had cage subsidence, 0.3% had a vascular injury, 0.3% had a ureteric injury, and no other visceral injuries were reported. Mean operative time was 226.2 ± 147.9 minutes. Mean EBL was 138.4 ± 215.6 mL. Mean hospital stay was 2.7 ± 2.2 days. Postoperative complications included new sensory symptoms-8.2%, new lower extremity weakness-5.8%, wound infection-1.4%, cage subsidence-0.8%, psoas hematoma-0.5%, small bowel obstruction and ischemia-0.3%, and 90-day readmission-1.9%. CONCLUSION: In this multicenter case series, the PTP approach was well tolerated and associated with a satisfactory safety profile.

Publication Date

6-5-2023

Publication Title

Neurosurgery

E-ISSN

1524-4040

PubMed ID

37272706

Digital Object Identifier (DOI)

10.1227/neu.0000000000002555

Recommended Citation

Soliman, Mohamed A.; Diaz-Aguilar, Luis; Kuo, Cathleen C.; Aguirre, Alexander O.; Khan, Asham; San Miguel-Ruiz, Jose E.; Amaral, Rodrigo; Abd-El-Barr, Muhammad M.; Moss, Isaac L.; Smith, Tyler; Deol, Gurvinder S.; Ehresman, Jeff; Battista, Madison; Lee, Bryan S.; McMains, M Craig; Joseph, Samuel A.; Schwartz, David; Nguyen, Andrew D.; Taylor, William R.; Pimenta, Luiz; and Pollina, John, "Complications of the Prone Transpsoas Lateral Lumbar Interbody Fusion for Degenerative Lumbar Spine Disease: A Multicenter Study" (2023). Neurosurgery. 1853.
https://scholar.barrowneuro.org/neurosurgery/1853