A new study published in The Spine Journal examines anterior lumbar spine surgery and risk factors for complications.
The researchers examined a literature review for English-language literature published from January 1992 to December 2013. MEDLINE helped researchers identify articles reporting complications with anterior lumbar spine surgery and there were 76 articles meeting criteria. There were 11,410 patients who underwent either arthrodesis and/or arthroplasty through laparoscopic, mini-open and open surgeries included in the study.
The researchers found:
1. Overall complication rate was 14.1 percent. The additional complication rates tracked include:
• Intraoperative: 9.1 percent
• Postoperative: 5.2 percent
2. There were around 3 percent of patients who required reoperation or revision procedures due to the complications.
3. The most common complications were:
• Venous injury: 3.2 percent
• Retrograde ejaculation: 2.7 percent
• Neurologic injury: 2 percent
• Prosthesis-related: 2 percent
• Postoperative ileus: 1.4 percent
• Superficial infection: 1 percent
4. The patients who underwent laparoscopic and transperioneal procedures had higher complication rates. The patients who underwent mini-open procedures had lower complication rates.
5. In procedures using rhBMP-2, there was a higher rate of retrograde ejaculation. But, the researchers note there are limitations to interpreting this data.
"Complication rates are related to surgical technique, approach and implant characteristics," concluded the study authors. "Further randomized controlled trials are needed to validate the use of preventative measures including CTA and the use of an access surgeon."
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