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Revista de la Asociación Argentina de Ortopedia y Traumatología
On-line version ISSN 1852-7434
Abstract
GOTTLIEB, Juan J and RESANO, Horacio. Complicaciones tempranas en los primeros 50 casos de cirugía mínimamente invasiva lateral a la columna lumbar. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2020, vol.85, n.1, pp.39-48. ISSN 1852-7434.
Introduction: Minimally invasive spine surgeries (MISS) are designed to improve postoperative morbidity in lumbar fusion procedures. Their limited surgical exposure and potentially poor visualization of the operative field are not without complications. The purpose of our study was to analyze our early postoperative complication rate in the first 50 patients that underwent a lateral MISS approach, evaluating these procedures in relation to our learning curve. Materials and Methods: We conducted a retrospective study in 50 patients that underwent lateral retroperitoneal interbody fusion using a MISS technique between September 2015 and April 2018. The assessed parameters were: demographic, radiological and surgical data, and all the early complications encountered. Results: A total of 76 cages were used: 5 at L1-L2 level; 33 at L2-L3 level; 34 at L3-L4 level; and 4 at L4-L5 level. Out of the 50 patients, 25 underwent fusion only at 1 level, 24 underwent fusion at 2 levels, and 1 underwent fusion at 3 levels. A total of 21 complications were encountered: 4 major complications, and 17 minor complications. The longest surgical time (90 minutes) and the highest complication rate were observed within cases 1-16 (12 patients). Thereafter, these parameters proportionately decreased until they reached a minimum of 3 complications within cases 34-50. Conclusions: The main complications occurred in the surgical access, and their incidence decreased as the surgeon’s experience increased and as the surgical time shortened.
Keywords : Lumbar lateral approach; XLIF; Complications.