A new study published in Spine examines the anterior lumbar interbody fusion procedure to determine the prevalence of vascular complications as a function of anatomic variation and the number of fused levels.
The researchers examined data from a prospectively collected spine database. There were 204 patients included in the study; 142 underwent single-level ALIF while 62 patients underwent multilevel procedures. The surgeries took place between 2008 and 2013.
The researchers reported:
1. There were 11 patients with postoperative thromboembolic events. Those patients were more likely to have intraoperative vascular injury than patients without vascular complications. Thirty-six percent of the patients with thromboembolic events reported vascular injury compared with 5 percent that did not.
2. Blood loss was higher in patients with spondylolisthesis — 520 cc — compared with patients who didn't have spondylolisthesis — 103 cc.
3. Patients with transitional anatomy reported 347 cc of blood loss compared with 262 cc of blood loss among patients who didn't have transitional anatomy.
4. The multilevel ALIF patients reported significantly higher blood loss — 684 cc — compared with the single-level patients, who reported 107 cc.
5. The patient's blood loss, anatomic variation and levels approached weren't associated with postoperative thromboembolic complication development. "Because patients with intraoperative vascular injury had increased likelihood of postoperative thromboembolic event, thrombosis prophylaxis should be considered in these patients," concluded the study authors.