Our Summary

This research paper is a review of the medical and surgical complications associated with a type of spinal surgery called Lateral Lumbar Interbody Fusion (LLIF). The study looked at data from 6,819 patients who had this procedure. The researchers were interested in understanding how often complications occurred in different categories, such as heart-related, vasculature, lungs, urinary system, digestive system, temporary neurological, persistent neurological, and musculoskeletal issues.

They found a total of 2,232 relevant articles and included 63 in their review. They discovered that temporary neurological complications were the most common, occurring in around 36% of patients. However, these complications tended to disappear after the immediate post-surgery period. Persistent neurological complications were much less frequent, happening in about 4% of patients.

Other complications such as wound issues, heart problems, lung issues, digestive system problems, urinary system problems, and musculoskeletal or spine issues occurred in less than 2% of patients.

This is the first study to look in-depth at the complications related to this type of spinal surgery. The findings can help surgeons understand what risks patients may face after the procedure and manage their expectations.

FAQs

  1. What is the most common complication associated with Lateral Lumbar Interbody Fusion (LLIF)?
  2. What percentage of patients experience persistent neurological complications after LLIF?
  3. What are the less common complications (occurring in less than 2% of patients) after undergoing Lateral Lumbar Interbody Fusion?

Doctor’s Tip

A helpful tip a doctor might give a patient about lumbar fusion is to follow all post-operative instructions carefully, including physical therapy exercises and restrictions on certain activities. It is important to communicate any unusual symptoms or concerns with your healthcare provider promptly to prevent and address any potential complications. Additionally, maintaining a healthy lifestyle with regular exercise, a balanced diet, and not smoking can help promote successful healing and recovery after lumbar fusion surgery.

Suitable For

Patients who are typically recommended lumbar fusion are those who have chronic lower back pain, degenerative disc disease, spinal instability, spondylolisthesis, spinal stenosis, or other conditions that have not responded to conservative treatments such as physical therapy, medications, and injections. Additionally, patients who have had previous spinal surgeries that have not been successful may also be candidates for lumbar fusion. It is important for patients to have a thorough evaluation by a spine specialist to determine if lumbar fusion is the best treatment option for their specific condition.

Timeline

Before lumbar fusion:

  1. Patient undergoes initial consultation with a spine specialist to determine if lumbar fusion is necessary.
  2. Patient undergoes pre-operative testing, such as X-rays, MRIs, and blood work.
  3. Patient receives instructions on pre-operative preparations, such as fasting and medication adjustments.
  4. Patient undergoes lumbar fusion surgery, which involves removing damaged disc tissue and fusing the vertebrae together.
  5. Patient stays in the hospital for a few days for monitoring and pain management.
  6. Patient begins physical therapy and rehabilitation to regain strength and mobility.

After lumbar fusion:

  1. Patient may experience temporary neurological complications, such as numbness or tingling in the legs, which usually resolve over time.
  2. Patient may experience persistent neurological complications, such as weakness or paralysis, which may require further treatment.
  3. Patient may experience other complications, such as wound issues, heart problems, lung issues, digestive system problems, urinary system problems, and musculoskeletal issues.
  4. Patient continues physical therapy and rehabilitation to gradually increase activity levels and improve function.
  5. Patient follows up with their surgeon for post-operative appointments and monitoring of healing progress.
  6. Patient gradually returns to normal activities and may experience improvement in their symptoms over time.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with lumbar fusion surgery?
  2. How likely am I to experience temporary neurological complications after the surgery?
  3. What measures will be taken to prevent complications during and after the surgery?
  4. How will you monitor my progress and recovery post-surgery to ensure complications are detected and managed promptly?
  5. What is the likelihood of developing persistent neurological complications after lumbar fusion surgery?
  6. How will you address any wound issues that may arise after the surgery?
  7. What steps will be taken to prevent heart, lung, digestive system, urinary system, and musculoskeletal issues post-surgery?
  8. How can I best prepare for surgery to minimize the risk of complications?
  9. Are there any specific factors that may increase my risk of complications during or after lumbar fusion surgery?
  10. What can I expect in terms of pain management and rehabilitation post-surgery to help prevent complications and promote a successful recovery?

Reference

Authors: Hijji FY, Narain AS, Bohl DD, Ahn J, Long WW, DiBattista JV, Kudaravalli KT, Singh K. Journal: Spine J. 2017 Oct;17(10):1412-1419. doi: 10.1016/j.spinee.2017.04.022. Epub 2017 Apr 26. PMID: 28456671