Perioperative Complications in 155 Patients Who Underwent Oblique Lateral Interbody Fusion Surgery: Perspectives and Indications From a Retrospective, Multicenter Survey.
METHODS
A retrospective multicenter survey.


OBJECTIVE
To investigate the perioperative complications of oblique lateral interbody fusion (OLIF) surgery.


BACKGROUND
OLIF has been widely performed to achieve minimally invasive, rigid lumbar lateral interbody fusion. The associated perioperative complications are not yet well described.


METHODS
The participants were patients who underwent OLIF surgery under the diagnosis of degenerative lumbar diseases between April 2013 and May 2015 at 11 affiliated medical institutions. The collected data were classified into intraoperative and early-stage postoperative (≤1 mo) complications. The intraoperative complications were then subcategorized into organ damage (neural, vertebral, vascular, and others) and other complications, mainly related to instrumental failure. The collected data were also divided and analyzed based on whether the surgeon was certified to perform the surgery and the incidence of complications in the early (April 2013-March 2014) and late stages (April 2014-May 2015) of OLIF introduction.


RESULTS
In the 155 included patients, 75 complications were reported (incidence rate, 48.3%). The most common complication was endplate fracture/subsidence (18.7%), followed by transient psoas weakness and thigh numbness (13.5%) and segmental artery injury (2.6%). Almost all these complications were transient, except for three patients who had permanent damage: one had ureteral injury and two had neurological injury. Postoperative complications included surgical site infection (1.9%) and reoperation (1.9%). Whether the primary operator was experienced did not affect the incidence of complications. Regarding the introductory stage, the incidence of complications was 50% in the early stage and 38% in the late stage.


CONCLUSIONS
The overall incidence of perioperative complications of OLIF surgery reached 48.3%, of which only 1.9% resulted in permanent damage. Our analysis based on surgeon experience indicated that the OLIF procedure could be performed without increasing incidence of complications, under the guidance of experienced supervisors.


METHODS
3.
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Koki
K
Abe
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Sumihisa
S
Orita
Department of Orthopaedic Surgery, Chiba Aoba Municipal Hospital, Chiba, Japan.
Chikato
C
Mannoji
Department of Orthopaedic Surgery, Chiba Aoba Municipal Hospital, Chiba, Japan.
Hiroyuki
H
Motegi
Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, Ichihara, Japan.
Masaaki
M
Aramomi
Department of Orthopaedic Surgery, Sanmu Medical Center, Sanmu, Japan.
Tetsuhiro
T
Ishikawa
Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan.
Toshiaki
T
Kotani
Department of Orthopaedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan.
Tsutomu
T
Akazawa
Department of Orthopaedic Surgery, Kashiwa Municipal Hospital, Kashiwa, Japan.
Tatsuo
T
Morinaga
Department of Orthopaedic Surgery, Kimitsu Central Hospital, Kisarazu, Japan.
Takayuki
T
Fujiyoshi
Department of Orthopaedic Surgery, Kimitsu Central Hospital, Kisarazu, Japan.
Fumio
F
Hasue
Department of Orthopaedic Surgery, Chiba Rosai Hospital, Ichihara, Japan.
Masatsune
M
Yamagata
Department of Orthopaedic Surgery, Chiba Rosai Hospital, Ichihara, Japan.
Mitsuhiro
M
Hashimoto
Department of Orthopaedic Surgery, Asahi General Hospital, Asahi, Japan.
Tomonori
T
Yamauchi
Department of Orthopaedic Surgery, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Japan.
Yawara
Y
Eguchi
Department of Orthopaedic Surgery, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Japan.
Munetaka
M
Suzuki
Department of Orthopaedic Surgery, JCHO Chiba Hospital, Chiba, Japan.
Eiji
E
Hanaoka
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Kazuhide
K
Inage
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Jun
J
Sato
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Kazuki
K
Fujimoto
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Yasuhiro
Y
Shiga
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Hirohito
H
Kanamoto
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Kazuyo
K
Yamauchi
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Junichi
J
Nakamura
Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
Takane
T
Suzuki
Department of Orthopaedic Surgery, The Back Center Back Pain Spine Surgery Melbourne Florida, FL.
Richard A
RA
Hynes
Department of Orthopaedic Surgery, East Chiba Medical Center, Togane, Japan.
Yasuchika
Y
Aoki
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Kazuhisa
K
Takahashi
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Seiji
S
Ohtori
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D007431:Intraoperative Complications / Q000453:epidemiology*; D017116:Low Back Pain / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011184:Postoperative Period; D012086:Reoperation; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult