title: Perioperative complications related to minimally invasive transforaminal lumbar fusion: evaluation of 204 operations on lumbar instability at single center.
abstract: BACKGROUND
  Minimally invasive transforaminal lumbar fusion (MIS-TLIF) has demonstrated efficacy in the treatment of lumbar degenerative diseases. The reported incidence of perioperative complications associated with MIS-TLIF surgery is highly variable. Studies concerning perioperative complications in broad patient populations are quite rare. This study analyzes a retrospectively collected database of patients who underwent an MIS-TLIF surgery at a single center.
  
  
  OBJECTIVE
  To determine the incidence of perioperaive complications with MIS-TLIF procedure based on our definition of Type I and II perioperative complications.
  
  
  METHODS
  Retrospective cohort study; a review of complications.
  
  
  METHODS
  The sample comprises 204 patients who underwent MIS-TLIF for the treatment of lumbar degenerative diseases.
  
  
  METHODS
  Type I complication including all medical adverse events without direct connection to the specific surgical procedure performed. Type II complication including adverse events with direct connection to the surgical procedure performed.
  
  
  METHODS
  A total of 204 MIS-TLIF surgeries on lumbar instability or spondylolisthesis, performed between June 2007 and July 2012, were examined in a retrospective study. A complication classification based on the relation to the surgical procedure and the effect duration was used. Perioperative complications until 1 month postoperatively were reviewed for the patients.
  
  
  RESULTS
  The study group comprised 204 patients (106 women, 98 men; mean age at surgery, 52.4 years; age range, 39-84 years). Overall, there were 75 perioperative complications in 204 patients (36.76%). Only one complication occurred in 54 patients. Nine patients had two complications. One patient had three complications. The incidence of perioperative complication was 31.37% (64/204 patients) in the MIS-TLIF operations. Of all complications, seven (9.33%) were classified as persistent complications and 68 (90.67%) were classified as transient complications. The incidence of Type I and II complications were 13.73% and 23.04%, respectively.
  
  
  CONCLUSIONS
  Minimally invasive transforaminal lumbar fusion has gained popularity as a procedure for the treatment of lumbar instability or spondylolisthesis, with similar complications as in the open surgery. Transient sensory disturbance was the most common complication in this series.
authors.affiliation: Department of Orthopaedic Surgery, Affiliated Xinqiao Hospital, The Third Military Medical University, No.2, Xinqiao St, Shapingba District, Chongqing 400037, China. Electronic address: tonywjxq@yahoo.com.cn.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, Affiliated Xinqiao Hospital, The Third Military Medical University, No.2, Xinqiao St, Shapingba District, Chongqing 400037, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D007431:Intraoperative Complications / Q000453:epidemiology*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D059035:Perioperative Period; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013168:Spondylolisthesis / Q000601:surgery*; D016896:Treatment Outcome
keywords: Complications; Degenerative lumbar diseases; Minimally invasive surgery; Minimally invasive transforaminal lumbar interbody fusion; Spine surgery; Spondylolisthesis