Abstract
Minimally invasive lumbar fusion is well described and is reported to offer significant
advantages to patients in terms of blood loss, a reduction in post-operative pain
and a quicker recovery. However, this technique may expose patients to a greater risk
of complications when compared to open lumbar instrumented fusion that may negate
these advantages. Between January 2007 and March 2001, we conducted a prospective
observational study of 100 consecutive patients (48 males and 52 females, mean age
of 54 years) to investigate complications occurring from minimally invasive lumbar interbody
fusion surgery using an image-guided technique. All patients underwent post-operative
CT scans to assess implant placement. Scanning was repeated at 6 months to assess bony fusion. We observed the following complications: 2.5% (11/435)
pedicle screw misplacement, 1.7% (2/120) interbody cage misplacement; 0.8% (1/120)
interbody cage migration; 0.8% (1/120) patients requiring a post-operative blood transfusion;
2% (2/100) venous thrombo-embolism and 3% (3/100) patients with complications thought
to be related to the use of bone morphogenic protein. There were no occurrences of
infection and no cerebrospinal fluid leaks. We concluded that the rate of complications
from minimally invasive lumbar interbody fusion is low, and compares favourably with
the rates of complication from open procedures. Moreover, computerised navigation
systems can be used in place of real-time fluoroscopy to guide implant placement,
without an increase in the rate of complications.
Keywords
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Article info
Publication history
Accepted:
May 5,
2012
Received:
February 1,
2012
Identification
Copyright
© 2012 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
