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Visceral, vascular, and wound complications following over 13,000 lateral interbody fusions: a survey study and literature review

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Abstract

Purpose

Minimally invasive lateral interbody fusion (MIS-LIF) has become a popular less invasive treatment option for degenerative spinal disease, deformity, and trauma. While MIS-LIF offers several advantages over traditional anterior and posterior approaches, the procedure is not without risk. The purpose of this study was to evaluate the incidence of visceral, vascular, and wound complications following MIS-LIF performed by experienced surgeons.

Methods

A survey was conducted by experienced (more than 100 case experience) MIS-LIF surgeons active in the society of lateral access surgery (SOLAS) to collect data on wound infections and visceral and vascular injuries. Of 77 spine surgeons surveyed, 40 (52 %) responded, including 25 (63 %) orthopedic surgeons and 15 (38 %) neurosurgeons, with 20 % practicing at an academic institution and 80 % in community practice.

Results

Between 2003 and 2013, 13,004 patients were treated with MIS-LIF by the 40 surgeons who responded to the survey. Of those patients, 0.08 % experienced a visceral complication (bowel injury), 0.10 % experienced a vascular injury, 0.27 % experienced a superficial wound infection, and 0.14 % experienced a deep wound infection.

Conclusion

The incidence of surgical site infections and vascular and visceral complications following MIS-LIF in this large series was low and compared favorably with rates for alternative interbody fusion approaches. Although technically demanding, MIS-LIF is a reproducible approach for interbody fusion with a low risk of vascular and visceral complications and infections.

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Acknowledgments

The authors would like to thanks Alessandria Struebing, MSPH and Kyle Malone, MS from NuVasive, Inc. for their editorial and administrative assistance on this work.

Conflict of interest

This work was not supported by any external sources of funding. One of the authors (JU) is a paid consultant and receives research grants from NuVasive, Inc. (San Diego, CA), which markets the extreme lateral interbody fusion (XLIF) procedure.

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Uribe, J.S., Deukmedjian, A.R. Visceral, vascular, and wound complications following over 13,000 lateral interbody fusions: a survey study and literature review. Eur Spine J 24 (Suppl 3), 386–396 (2015). https://doi.org/10.1007/s00586-015-3806-4

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