Nationwide Survey of the Surgical Complications Associated with Lateral Lumbar Interbody Fusion in 2018

• Published in: Journal of Spine Research Vol. 12; no. 1.2; pp. 38 - 44
• Main Authors: Yagi, Mitsuru, Ishii, Ken, Iwasaki, Motoki, Inoue, Gen, Ohtori, Seiji, Orita, Sumihisa, Kanemura, Tokumi, Kotani, Toshiaki, Sairyo, Koichi, Sakai, Daisuke, Sudo, Hideki, Takahashi, Jun, Taneichi, Hiroshi, Togawa, Daisuke, Nakamura, Masaya, Hasagawa, Tomohiko, Fujibayashi, Shunsuke, Yoshii, Toshitaka, Wakao, Norimitsu, Watanabe, Masahiko, Hosogane, Naobumi
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Spine Surgery and Related Research 20.01.2021
• Subjects: complications; LIF; national survey
• ISSN: 1884-7137; 2435-1563
• DOI: 10.34371/jspineres.2020-0026

Background: Recently, lateral lumbar interbody fusion (LIF) including eXtreme lateral lnterbody fusion (XLIF), direct lateral interbody fusion (DLIF), and oblique lateral interbody fusion (OLIF), has been introduced in Japan. Despite the effectiveness of this procedure, several complications have been reported. Since 2015, to identify the overall complication rate and type, the Japanese Society for Spine Surgery and Related Research (JSSR) has started a nationwide survey on the incidence and the type of complications related to LIF among all JSSR members.Purpose: To report the results of a nationwide survey performed by JSSR on complications in LIF performed in Japan in 2018Methods: A web-based survey on the complications following LIF was performed by JSSR for all JSSR members. Any complications meeting the criteria listed below have been included: (1) major vessel injury, (2) urinary tract injury, (3) renal injury, (4) visceral organ injury, (5) lung injury, (6) weakness of psoas, (7) motor deficit, (8) sensory deficit, (9) vertebral injury, (10) nerve injury, (11) anterior longitudinal ligament injury, (12) surgical site infection (SSI), and (13) other complications. Incidence and type of complications were analyzed in all LIF cases, and the difference in incidence and the type of complications between XLIF and OLIF were also compared.Results: Among the 2,354 LIF cases (XLIF: 1,130 cases [48%], DLIF: 21 cases [0.9%], and OLIF: 1,230 cases [51%]), complications occurred in 54 (2.3%) cases. The most common complications were motor deficit (0.34%) and SSI (0.34%), followed by sensory deficit (0.25%) and major vessel injury (0.17%). Eighteen (30% of all complications and 0.8% of all cases) cases required revision surgery during the survey period. There were three (0.1%) cases of mortality cases due to complications of this surgery. There was no statistically significant difference in the frequency of complications between XLIF and OLIF (2.7% vs.1.7%, p = 0.10).Conclusion: We conducted a nationwide survey on complications following LIF surgery. The overall complication rate was 2.3%, and 0.8% of cases required revision surgery related to complications. Three mortality cases occurred due to complications. Future detailed studies are recommended to evaluate severe complications to mitigate the risk of mortality in this procedure.