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Brain Science Advances 2019, 5(3): 213-219 https://doi.org/10.26599/BSA.2019.9050019
Research Article | Open Access | Issue | Published: 17 April 2020

Instrumentation-related complications of lumbar degenerative disc diseases treated by minimally invasive transforaminal lumbar interbody fusion

Show Author's Information Xinyu Yang,  Xinyu Liu( )
Department of Orthopedics, Qilu Hospital of Shandong University, Ji’nan 250012, Shandong, China
Keywords:
lumbar, degenerative diseases, minimally invasive surgery, transforaminal lumbar interbody fusion, instrumentation, complication
Cite this article:
Yang X, Liu X. Instrumentation-related complications of lumbar degenerative disc diseases treated by minimally invasive transforaminal lumbar interbody fusion. Brain Science Advances, 2019, 5(3): 213-219. https://doi.org/10.26599/BSA.2019.9050019
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Abstract Full text About this article
Objective:

To analyze the instrumentation-related complications of patients with lumbar degenerative disc diseases (LDD) who underwent minimally invasive transforaminal lumbar interbody fusion (MIS- TLIF) and to discuss the potential strategy for the control of these complications.

Methods:

A total of 87 patients with LDD were treated with the MIS-TLIF procedure. Complications, including malposition or breakage of guide pin, percutaneous pedicle screw (PPS) or cages, neurological deficit, and superior-level facet joint violations, were determined during and after the surgery. Computed tomography (CT) was used to evaluate the PPS accuracy and the superior-level facet joint violations.

Results:

A total of 386 PPSs were used. During the surgery, 3 (0.8%) guide pin and 1 (0.3%) PPS perforated the anterior wall of the vertebral body, respectively. One (0.3%) PPS was pulled out during the reduction of slip. Malposition of the cages occurred in 6 (1.6%) PPSs. These were all adjusted accordingly during the surgery. All the patients received > 2 years of follow-up. No loosening or breakage of PPS and cage was observed, but CT showed 27 (7.0%) PPSs misplaced. No neurological deficit related to misplaced PPS was observed. The total facet joint violation (FJV) rate was 36.2%, with grade 2 and grade 3 violations is 21 (12.1%) and 6 (3.4%), respectively.

Conclusion:

MIS-TLIF has similar instrumentation-related complications with open TLIF. Accurate preoperative evaluation and improved surgical techniques can effectively reduce these instrumentation-related complications.


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Abstract
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About this article

Instrumentation-related complications of lumbar degenerative disc diseases treated by minimally invasive transforaminal lumbar interbody fusion

Show Author's information Xinyu Yang, Xinyu Liu( )
Department of Orthopedics, Qilu Hospital of Shandong University, Ji’nan 250012, Shandong, China

Abstract

Objective:

To analyze the instrumentation-related complications of patients with lumbar degenerative disc diseases (LDD) who underwent minimally invasive transforaminal lumbar interbody fusion (MIS- TLIF) and to discuss the potential strategy for the control of these complications.

Methods:

A total of 87 patients with LDD were treated with the MIS-TLIF procedure. Complications, including malposition or breakage of guide pin, percutaneous pedicle screw (PPS) or cages, neurological deficit, and superior-level facet joint violations, were determined during and after the surgery. Computed tomography (CT) was used to evaluate the PPS accuracy and the superior-level facet joint violations.

Results:

A total of 386 PPSs were used. During the surgery, 3 (0.8%) guide pin and 1 (0.3%) PPS perforated the anterior wall of the vertebral body, respectively. One (0.3%) PPS was pulled out during the reduction of slip. Malposition of the cages occurred in 6 (1.6%) PPSs. These were all adjusted accordingly during the surgery. All the patients received > 2 years of follow-up. No loosening or breakage of PPS and cage was observed, but CT showed 27 (7.0%) PPSs misplaced. No neurological deficit related to misplaced PPS was observed. The total facet joint violation (FJV) rate was 36.2%, with grade 2 and grade 3 violations is 21 (12.1%) and 6 (3.4%), respectively.

Conclusion:

MIS-TLIF has similar instrumentation-related complications with open TLIF. Accurate preoperative evaluation and improved surgical techniques can effectively reduce these instrumentation-related complications.

Keywords: lumbar, degenerative diseases, minimally invasive surgery, transforaminal lumbar interbody fusion, instrumentation, complication

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Publication history
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Publication history

Received: 22 July 2019
Revised: 06 September 2019
Accepted: 15 September 2019
Published: 17 April 2020
Issue date: September 2019

Copyright

© The authors 2019

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 81272024).

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Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage)

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