scholarly journals The Negligible Influence of Chronic Obesity on Hospitalization, Clinical Status, and Complications in Elective Posterior Lumbar Interbody Fusion

2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
Olaf Suess ◽  
Theodoros Kombos ◽  
Frank Bode
Keyword(s):  
Interbody Fusion ◽  
Clinical Status ◽  
Operating Time ◽  
Posterior Lumbar Interbody Fusion ◽  
The Body ◽  
Cerebrospinal Fluid Leakage ◽  
Wound Complications ◽  
Spinal Instability ◽  
Lumbar Interbody Fusion ◽  
Implant Complications

Background. Posterior lumbar interbody fusion (PLIF) is a common surgical treatment for degenerative spinal instability, but many surgeons consider obesity a contraindication for elective spinal fusion. The aim of this study was to analyze whether obesity has any influence on hospitalization parameters, change in clinical status, or complications.Methods. In this prospective study, regression analysis was used to analyze the influence of the body mass index (BMI) on operating time, postoperative care, hospitalization time, type of postdischarge care, change in paresis or sensory deficits, pain level, wound complications, cerebrospinal fluid leakage, and implant complications.Results. Operating time increased only 2.5 minutes for each increase of BMI by 1. The probability of having a wound complication increased statistically with rising BMI. Nonetheless, BMI accounted for very little of the variation in the data, meaning that other factors or random chances play a much larger role.Conclusions. Obesity has to be considered a risk factor for wound complications in patients undergoing elective PLIF for degenerative instability. However, BMI showed no significant influence on other kinds of peri- or postoperative complications, nor clinical outcomes. So obesity cannot be considered a contraindication for elective PLIF.

scholarly journals Microendoscope-Assisted Versus Open Posterior Lumbar Interbody Fusion for Lumbar Degenerative Disease: A Multicenter Retrospective Cohort Study

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 150
Author(s):  
Masayoshi Fukushima ◽  
Nozomu Ohtomo ◽  
Michita Noma ◽  
Yudai Kumanomido ◽  
Hiroyuki Nakarai ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Intraoperative Complications ◽  
Operating Time ◽  
Posterior Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Open Group ◽  
Lumbar Interbody Fusion ◽  
Lumbar Degenerative Disease ◽  
Radiographic Findings ◽  
One Year

Background and objectives: Minimally invasive surgery has become popular for posterior lumbar interbody fusion (PLIF). Microendoscope-assisted PLIF (ME-PLIF) utilizes a microendoscope within a tubular retractor for PLIF procedures; however, there are no published reports that compare Microendoscope-assisted to open PLIF. Here we compare the surgical and clinical outcomes of ME-PLIF with those of open PLIF. Materials and Methods: A total of 155 consecutive patients who underwent single-level PLIF were registered prospectively. Of the 149 patients with a complete set of preoperative data, 72 patients underwent ME-PLIF (ME-group), and 77 underwent open PLIF (open-group). Clinical and radiographic findings collected one year after surgery were compared. Results: Of the 149 patients, 57 patients in ME-group and 58 patients in the open-group were available. The ME-PLIF procedure required a significantly shorter operating time and involved less intraoperative blood loss. Three patients in both groups reported dural tears as intraoperative complications. Three patients in ME-group experienced postoperative complications, compared to two patients in the open-group. The fusion rate in ME-group at one year was lower than that in the open group (p = 0.06). The proportion of patients who were satisfied was significantly higher in the ME-group (p = 0.02). Conclusions: ME-PLIF was associated with equivalent post-surgical outcomes and significantly higher rates of patient satisfaction than the traditional open PLIF procedure. However, the fusion rate after ME-PLIF tended to be lower than that after the traditional open method.

scholarly journals Perioperative Hypoalbuminemia is a Risk Factor for Wound Complications Following Posterior Lumbar Interbody Fusion

2020 ◽  
Author(s):  
Zhongyuan He ◽  
Kai Zhou ◽  
Ke Tang ◽  
Zhengxue Quan ◽  
Shaoyu Liu ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Wound Complications ◽  
Lumbar Interbody Fusion ◽  
Lumbar Degenerative Disease ◽  
Single Segment ◽  
Preoperative Serum ◽  
Hospitalization Costs ◽  
Postoperative Serum

Abstract Background: Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains ambiguous. The aim of this study was to evaluate perioperative serum albumin in relation to postoperative wound complications after posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease. Material and methods: We reviewed patients who underwent single-segment posterior lumbar interbody fusion surgery from December 2014 to April 2017 in the Department of Orthopedics at the First Affiliated Hospital of Chongqing Medical University. Perioperative (preoperative and early postoperative) serum albumin levels were assessed in all patients and were used to quantify nutritional status. We divided the patients into a surgical wound dehiscence (SWD) group and a normal wound healing group, and into a surgical site infection(SSI)group and a non-SSI group. To evaluate the relationship between perioperative serum albumin level and postoperative wound complications, we conducted univariate and multiple logistic regression analyses.Results: A total of 554 patients were enrolled in the study.The univariate and multiple logistic regression analysis of these differences showed that preoperative serum albumin <3.5 g/dl and postoperative serum albumin:<3.0 g/dl were significantly related to SWD (P<0.05). There were also significant differences between the surgical site infection(SSI) groups in terms of preoperative serum albumin <3.5 g/dl(P=0.001), postoperative serum albumin <3.5 g/dl (P<0.023) and <3.0 g/dl(P<0.001).Additionally, the increased hospitalization costs and length of hospitalization were statistically significant for patients with perioperative hypoalbuminemia. Conclusions: For patients who underwent single-segment posterior lumbar interbody fusion surgery, we need to pay more attention to steroid use, perioperative hypoalbuminemia, which are more likely to be associated with increased wound complications, hospitalization costs and length of hospitalization after surgery. Adequate assessment and management of these risk factors will help reduce wound complications and hospital stays for surgical patients and will save medical costs.

scholarly journals Perioperative Hypoalbuminemia is a Risk Factor for Wound Complications Following Posterior Lumbar Interbody Fusion

2020 ◽  
Author(s):  
Zhongyuan He ◽  
Kai Zhou ◽  
Ke Tang ◽  
Zhengxue Quan ◽  
Shaoyu Liu ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Wound Complications ◽  
Lumbar Interbody Fusion ◽  
Lumbar Degenerative Disease ◽  
Single Segment ◽  
Preoperative Serum ◽  
Hospitalization Costs ◽  
Postoperative Serum

Abstract Background: Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains ambiguous. The aim of this study was to evaluate perioperative serum albumin in relation to postoperative wound complications after posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease. Material and methods: We reviewed patients who underwent single-segment posterior lumbar interbody fusion surgery from December 2014 to April 2017 in the Department of Orthopedics at the First Affiliated Hospital of Chongqing Medical University. Perioperative (preoperative and early postoperative) serum albumin levels were assessed in all patients and were used to quantify nutritional status. We divided the patients into a surgical wound dehiscence (SWD) group and a normal wound healing group, and into a surgical site infection (SSI) group and a non-SSI group. To evaluate the relationship between perioperative serum albumin level and postoperative wound complications, we conducted univariate and multiple logistic regression analyses.Results: A total of 554 patients were enrolled in the study. The univariate and multiple logistic regression analysis of these differences showed that preoperative serum albumin <3.5 g/dl (P =0.001) and postoperative serum albumin <3.0 g/dl (P =0.001) were significantly correlated to SWD. There were also significant differences between the SSI groups in terms of preoperative serum albumin <3.5 g/dl (P=0.001), Chronic steroid use (P=0.003). Additionally, the increased hospitalization costs (P<0.001) and length of hospitalization (P<0.001) were statistically significant for patients with perioperative hypoalbuminemia. Conclusions: For patients who underwent single-segment posterior lumbar interbody fusion surgery, we need to pay more attention to perioperative hypoalbuminemia and chronic steroid use,which are more likely to be associated with increased wound complications, hospitalization costs and length of hospitalization after surgery. Adequate assessment and management of these risk factors will help reduce wound complications and hospital stays for surgical patients and will save medical costs.

scholarly journals Perioperative Hypoalbuminemia is a Risk Factor for Wound Complications Following Posterior Lumbar Interbody Fusion

2020 ◽  
Author(s):  
Zhongyuan He ◽  
Kai Zhou ◽  
Ke Tang ◽  
Zhengxue Quan ◽  
Shaoyu Liu ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Wound Complications ◽  
Lumbar Interbody Fusion ◽  
Single Segment ◽  
Preoperative Serum ◽  
Hospitalization Costs ◽  
Postoperative Serum ◽  
The Relationship

Abstract Background: Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains ambiguous. The aim of this study was to evaluate perioperative serum albumin in relation to postoperative wound complications after posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease.Material and methods : We reviewed patients who underwent single-segment posterior lumbar interbody fusion surgery from December 2014 to April 2017 in the Department of Orthopedics at the First Affiliated Hospital of Chongqing Medical University. Perioperative (preoperative and early postoperative) serum albumin levels were assessed in all patients and were used to quantify nutritional status. We divided the patients into a surgical wound dehiscence ( SWD ) group and a normal wound healing group, and into an surgical site infection(SSI)group and a non-SSI group. To evaluate the relationship between perioperative serum albumin level and postoperative wound complications, we conducted univariate and multiple logistic regression analyses.Results: A total of 554 patients were enrolled in the study.The univariate and multiple logistic regression analysis of these differences showed that preoperative serum albumin <3.5 g/dl and postoperative serum albumin:<3.0 g/dl were significantly related to SWD (P<0.05). There were also significant differences between the surgical site infection (SSI) groups in terms of preoperative serum albumin <3.5 g/dl(P=0.001), postoperative serum albumin <3.5 g/dl (P<0.023) and <3.0 g/dl(P<0.001).Additionally, the increased hospitalization costs and length of hospitalization were statistically significant for patients with perioperative hypoproteinemia.Conclusions: For patients who underwent single-segment posterior lumbar interbody fusion surgery, we need to pay more attention to steroid use,perioperative hypoalbuminemia, which are more likely to be associated with increased wound complications, hospitalization costs and length of hospitalization after surgery. Adequate assessment and management of these risk factors will help reduce wound complications and hospital stays for surgical patients and will save medical costs.

scholarly journals Perioperative hypoalbuminemia is a risk factor for wound complications following posterior lumbar interbody fusion

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Zhongyuan He ◽  
Kai Zhou ◽  
Ke Tang ◽  
Zhengxue Quan ◽  
Shaoyu Liu ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Wound Complications ◽  
Lumbar Interbody Fusion ◽  
Lumbar Degenerative Disease ◽  
Single Segment ◽  
Preoperative Serum ◽  
Hospitalization Costs ◽  
Postoperative Serum

Abstract Background Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains ambiguous. The aim of this study was to evaluate perioperative serum albumin in relation to postoperative wound complications after posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease. Material and methods We reviewed patients who underwent single-segment posterior lumbar interbody fusion surgery from December 2014 to April 2017 in the Department of Orthopedics at the First Affiliated Hospital of Chongqing Medical University. Perioperative (preoperative and early postoperative) serum albumin levels were assessed in all patients and were used to quantify nutritional status. We divided the patients into a surgical wound dehiscence (SWD) group and a normal wound healing group and into a surgical site infection (SSI) group and a non-SSI group. To evaluate the relationship between perioperative serum albumin level and postoperative wound complications, we conducted univariate and multiple logistic regression analyses. Results A total of 554 patients were enrolled in the study. The univariate and multiple logistic regression analysis of these differences showed that preoperative serum albumin < 3.5 g/dl (P = 0.001) and postoperative serum albumin < 3.0 g/dl (P = 0.001) were significantly correlated to SWD. There were also significant differences between the SSI groups in terms of preoperative serum albumin < 3.5 g/dl (P = 0.001) and chronic steroid use (P = 0.003). Additionally, the increased hospitalization costs (P < 0.001) and length of hospitalization (P < 0.001) were statistically significant for patients with perioperative hypoalbuminemia. Conclusions For patients who underwent single-segment posterior lumbar interbody fusion surgery, we need to pay more attention to perioperative hypoalbuminemia and chronic steroid use, which are more likely to be associated with increased wound complications, hospitalization costs, and length of hospitalization after surgery. Adequate assessment and management of these risk factors will help reduce wound complications and hospital stays for surgical patients and will save medical costs.

Complications of posterior lumbar interbody fusion when using a titanium threaded cage device

2000 ◽  
Vol 93 (1) ◽  
pp. 45-52 ◽  
Author(s):  
W. Jeffrey Elias ◽  
Nathan E. Simmons ◽  
George J. Kaptain ◽  
James B. Chadduck ◽  
Richard Whitehill
Keyword(s):  
Back Pain ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Motor Deficit ◽  
Spinal Instability ◽  
Graft Material ◽  
Lumbar Interbody Fusion ◽  
Content Type ◽  
Flexion Extension ◽  
Fine Print

Object. The authors reviewed their series of patients to quantify clinical and radiographic complications in those who underwent a posterior lumbar interbody fusion (PLIF) procedure in which a threaded interbody cage (TIC) was implanted. Methods. Sixty-seven patients underwent a posterior lumbar interbody fusion procedure in which a TIC was used. The authors excluded patients who underwent procedures in which other instrumentation was used or a nondorsal approach was performed. Fifteen percent of the cases (10 patients) were complicated by laceration of the dura. In three cases, bilateral implantation could not be performed. The average blood loss was 670 ml for all cases, and blood transfusion was required in 25% of the cases (17 patients). The rate of minor wound complication was 4.5% (three patients). One patient died. The average period of hospitalization was 4.25 days. Twenty-eight patients (42%) experienced significant low-back pain 3 months postoperatively, and in 10 (15%) of these cases it persisted beyond 1 year. In 10 patients postoperative radiculopathy was demonstrated, and magnetic resonance imaging revealed epidural fibrosis in six patients, arachnoiditis in one, and a recurrent disc herniation in one. One patient incurred a permanent motor deficit with sexual dysfunction. Pseudarthrosis was suggested radiographically with evidence of motion on lateral flexion—extension radiographs (10 cases), lucencies around the implants (seven cases), and posterior migration of the cage (two cases). Additional procedures (in 14 patients) consisted primarily of transverse process fusion with pedicle screw and plate augmentation for persistent back pain and radiographically demonstrated signs of spinal instability. In two patients with radiculopathy, migration of the TIC required that it be removed. Graft material that extruded from one implant necessitated its removal. In one patient scarectomy was performed. Conclusions. Our high incidence of TIC-related complications in PLIF is inconsistent with that reported in previous studies.

scholarly journals Perioperative Hypoalbuminemia is a Risk Factor for Wound Complications Following Posterior Lumbar Interbody Fusion

2020 ◽  
Author(s):  
Zhongyuan He ◽  
Kai Zhou ◽  
Weiyang Zhong ◽  
Ke Tang ◽  
Zhengxue Quan ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Wound Complications ◽  
Lumbar Interbody Fusion ◽  
Lumbar Degenerative Disease ◽  
Single Segment ◽  
Preoperative Serum ◽  
Hospitalization Costs ◽  
Postoperative Serum

Abstract Abstract Background: Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains ambiguous. The aim of this study was to evaluate perioperative serum albumin in relation to postoperative wound complications after posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease. Methods: We reviewed patients who underwent single-segment posterior lumbar interbody fusion surgery from December 2014 to April 2017 in the Department of Orthopedics at the First Affiliated Hospital of Chongqing Medical University. Perioperative (preoperative and early postoperative) serum albumin levels were assessed in all patients and were used to quantify nutritional status. We divided the patients into a surgical wound dehiscence ( SWD ) group and a normal wound healing group, and into an surgical site infection(SSI)group and a non-SSI group. To evaluate the relationship between perioperative serum albumin level and postoperative wound complications, we conducted univariate and multiple logistic regression analyses. Results: A total of 554 patients were enrolled in the study.The univariate and multiple logistic regression analysis of these differences showed that preoperative serum albumin <3.5 g/dl and postoperative serum albumin:<3.0 g/dl were significantly related to SWD (P<0.05). There were also significant differences between the surgical site infection (SSI) groups in terms of preoperative serum albumin <3.5 g/dl(P=0.001), postoperative serum albumin <3.5 g/dl (P<0.023) and <3.0 g/dl(P<0.001).Additionally, the increased hospitalization costs and length of hospitalization were statistically significant for patients with perioperative hypoproteinemia. Conclusions: For patients who underwent single-segment posterior lumbar interbody fusion surgery, we need to pay more attention to steroid use,perioperative hypoalbuminemia, which are more likely to be associated with increased wound complications, hospitalization costs and length of hospitalization after surgery. Adequate assessment and management of these risk factors will help reduce wound complications and hospital stays for surgical patients and will save medical costs. Keywords: hypoalbuminemia,malnutrition,risk factors,single-segment lumbar fusion,postoperative incision complications,retrospective studies.

scholarly journals Frailty Is Predictive of Adverse Postoperative Events in Patients Undergoing Lumbar Fusion

2017 ◽  
Vol 7 (6) ◽  
pp. 529-535 ◽  
Author(s):  
Dante M. Leven ◽  
Nathan J. Lee ◽  
Jun S. Kim ◽  
Parth Kothari ◽  
Jeremy Steinberger ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Frailty Index ◽  
Multivariate Logistic Regression Analysis ◽  
Posterior Lumbar Interbody Fusion ◽  
Wound Complications ◽  
Lumbar Interbody Fusion ◽  
Improvement Program ◽  
Prolonged Length

Study Design: Retrospective study of prospectively collected data. Objective: To analyze the modified frailty index (mFI) as a predictor of adverse postoperative events following posterior lumbar fusion. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database including all adult patients undergoing posterior lumbar interbody fusion or transforaminal lumbar interbody fusion between 2005 and 2012. Outcomes measured included mortality, postoperative complications, length of stay, reoperations, and readmissions. The previously described mFI was calculated, and univariate and multivariate logistic regression analysis were used to analyze risk factors associated with morbidity, mortality, and adverse postoperative events. This study was qualified as exempt by the Mount Sinai Hospital Institutional Review Board. Results: A total of 6094 patients met inclusion criteria. The mean mFI was 0.087(0-0.545). Increasing mFI score was associated with increased complications, reoperations, prolonged length of stay (LOS), and morbidity ( P < .05). As the mFI score increased from 0.27 (3/11 variables present) to ≥0.36 (4/11), the rate of any complication increased from 26.8% to 35% ( P < .0001), sepsis 2.4% to 5.2% ( P < .0001), wound complications 4.4% to 6.5% ( P < .0001), unplanned readmissions 4.7% to 20% ( P = .02), and urinary tract infection 4.1% to 10.4% ( P < .0001). An mFI of ≥0.36 was an independent predictor of any complication (odds ratio [OR]= 2.2, 95% confidence interval [CI] = 1.3-3.7), sepsis (OR = 6.3, 95%, CI = 1.8-21), wound complications (OR = 2.9, 95% CI = 1.1-8.2), prolonged LOS (OR = 2.3, 95% CI = 1.4-3.7), and readmission (OR = 4.3, 95% CI = 1.5-12.7). Conclusion: Patients with higher mFI scores (≥ 4/11 variables) are at a significantly higher risk of major complications, readmissions, and prolonged LOS following lumbar fusion.

scholarly journals Perioperative Hypoalbuminemia is a Risk Factor for Wound Complications Following Posterior Lumbar Interbody Fusion

2020 ◽  
Author(s):  
Zhongyuan He ◽  
Kai Zhou ◽  
Ke Tang ◽  
Zhengxue Quan ◽  
Shaoyu Liu ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Wound Complications ◽  
Lumbar Interbody Fusion ◽  
Lumbar Degenerative Disease ◽  
Single Segment ◽  
Preoperative Serum ◽  
Hospitalization Costs ◽  
Postoperative Serum

Abstract Background: Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains ambiguous. The aim of this study was to evaluate perioperative serum albumin in relation to postoperative wound complications after posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease.Material and methods: We reviewed patients who underwent single-segment posterior lumbar interbody fusion surgery from December 2014 to April 2017 in the Department of Orthopedics at the First Affiliated Hospital of Chongqing Medical University. Perioperative (preoperative and early postoperative) serum albumin levels were assessed in all patients and were used to quantify nutritional status. We divided the patients into a surgical wound dehiscence (SWD) group and a normal wound healing group, and into a surgical site infection (SSI) group and a non-SSI group. To evaluate the relationship between perioperative serum albumin level and postoperative wound complications, we conducted univariate and multiple logistic regression analyses.Results: A total of 554 patients were enrolled in the study. The univariate and multiple logistic regression analysis of these differences showed that preoperative serum albumin <3.5 g/dl (P =0.001) and postoperative serum albumin <3.0 g/dl (P =0.001) were significantly correlated to SWD. There were also significant differences between the SSI groups in terms of preoperative serum albumin <3.5 g/dl (P=0.001), Chronic steroid use (P=0.003). Additionally, the increased hospitalization costs (P<0.001) and length of hospitalization (P<0.001) were statistically significant for patients with perioperative hypoalbuminemia.Conclusions: For patients who underwent single-segment posterior lumbar interbody fusion surgery, we need to pay more attention to perioperative hypoalbuminemia and chronic steroid use, which are more likely to be associated with increased wound complications, hospitalization costs and length of hospitalization after surgery. Adequate assessment and management of these risk factors will help reduce wound complications and hospital stays for surgical patients and will save medical costs.

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