title: Vertebral body fractures after transpsoas interbody fusion procedures.
abstract: BACKGROUND
  Although the frequency of transpsoas lumbar interbody fusion procedures has increased in recent years, complication reports remain scarce in the literature.
  
  
  OBJECTIVE
  To present four cases of vertebral body fracture after transpsoas interbody fusion procedures in nonosteoporotic patients without significant trauma and discuss relevant biomechanical factors.
  
  
  METHODS
  Case series and literature review.
  
  
  METHODS
  Patients 1 and 2 were obese men who underwent one- and two-level transpsoas interbody fusion procedures and subsequently experienced coronal plane fracture. Patients 3 and 4 were elderly women who underwent multilevel transpsoas interbody fusion procedures and experienced L5 compression fracture.
  
  
  RESULTS
  Patients 2 and 3 were treated nonsurgically after fracture. The fractures healed uneventfully; however, Patient 3 developed a flat back syndrome. Patient 1 underwent posterior instrumented fusion and had solid bridging bone above and below the fracture. Patient 4 was treated with vertebroplasty. Factors potentially contributing to these fractures were discussed.
  
  
  CONCLUSIONS
  Fracture can occur after transpsoas lumbar interbody fusion, even in nonosteoporotic patients. Factors, such as intraoperative end-plate breach, subsidence, compression by lateral screws, and cage rolling, could contribute to the development of fractures after transpsoas interbody fusion.
authors: Orthopaedic Biomechanics Laboratory, Department of Orthopaedic Surgery, Loma Linda University, 11406 Loma Linda Drive, Suite 213, Loma Linda, CA 92354, USA.
authors: Justin E
authors: JE
authors: Brier-Jones
authors: Daniel K
authors: DK
authors: Palmer
authors: Serkan
authors: S
authors: Ĭnceoğlu
authors: Wayne K
authors: WK
authors: Cheng
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods*