title: Postoperative Complications Within the First Year After Extreme Lateral Interbody Fusion: Experience of the First 108 Patients.
abstract: METHODS
  Retrospective chart review.
  
  
  OBJECTIVE
  To determine complications within the first year after undergoing extreme lateral interbody fusion (XLIF).
  
  
  BACKGROUND
  There are a growing but limited number of reports in the literature regarding early postoperative complications after XLIF.
  
  
  METHODS
  We performed a retrospective chart review of perioperative complications of a case series of the first 108 patients to undergo XLIF at our institution between 2007 and 2009. We also recorded estimated blood loss, surgical time, and hospital length of stay for each procedure.
  
  
  RESULTS
  There were 25 complications (23%) overall in patients who underwent the XLIF procedure. Four patients (3.7%) experienced major complications including: vertebral body fracture, contralateral nerve root injury, dense quadriceps paresis, and persistent stenosis. Three of these patients underwent revision surgery. There were 21 minor (19.4%) complications the vast majority of which consisted of approach-related thigh pain and/or paresthesias that all ultimately resolved.
  
  
  CONCLUSIONS
  Transient ipsilateral thigh numbness, pain, and/or hip flexor weakness is a frequent postoperative finding most commonly when the L4-L5 level is instrumented. Dense femoral nerve palsy is a debilitating complication that may occur despite intraoperative neurophysiological monitoring. It should be noted that this retrospective study may underreport the true incidence of complications among these patients.
authors.affiliation: *Resurgens Orthopaedics Spine Center, Marietta, GA†Deparment of Orthopaedics, Carolinas Medical Center, Charlotte, NC‡Southeastern Spine Institute, Mt Pleasant, SC.
authors.forename: Bennett D
authors.initials: BD
authors.lastname: Grimm
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Leas
authors.forename: Steven C
authors.initials: SC
authors.lastname: Poletti
authors.forename: Donald R
authors.initials: DR
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D003710:Demography; D005260:Female; D006801:Humans; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D013123:Spinal Fusion / Q000009:adverse effects*