Results: Direct Lateral Transpsoas Approach

Male surgical patient with male doctor in backroundThe average age of this patient group was 64.6 years (range 39 to 83 years). Hospital stay and estimated blood loss were increased in cases requiring posterolateral fusion with instrumentation versus percutaneous posterior tension band (PPTB), anterior stand-alone (SA) or anterior instrumentation (AI) cases (Table 2). Anterior column support was accomplished with multiple interbody devices including cylindrical metal and bone or tapered PEEK with rh-BMP 2. Complications, adverse events that altered discharge plan or patient function, occurred in 10/38 patients (Table 3). No intra-abdominal visceral injuries, dural tears, complaints of retrograde ejaculation or infection occurred in this series.

Table 2: Series Operative & Hospital Stay Data

Procedure: DLIF with
Levels
EBL
OR Time
HS
Anterior Instrumentation
1.3
137.5
141.2
3.3
Stand Alone
1.1
49.4
91.9
2.1
PPTB
1.6
136.2
207.8
3.4
PSF
2
336.8
255.7
7.3

DLIF = direct lateral interbody fusion
EBL = estimated blood loss
HS = hospital stay
OR = operating room
PPTB = percutaneous posterior tension band
PSF = posterior spinal fusion

Table 3: Complications

Patient
Age
Sex
Interspace
Procedure Type Implant Shape Complication Type
DC
57
f
L2-3
Anterior Instrumentation Bullet Myocardial infarction Medical
MR
80
m
L2-3
Stand Alone Cylinder Dementia Medical
DR
53
m
L2-4
Anterior Instrumentation Bullet Psoas spasm Approach
ES
72
f
L2-4
Anterior Instrumentation Bullet Meralgia paresthetica Approach
RS
70
f
L2-4
PPI Bone Dowel Broken cable Implant
IY
77
f
L2-5
OPI Bullet Meralgia paresthetica Approach
JS
70
f
L3-4
Stand Alone Cylinder Loss of fixation Implant
DW
71
m
L3-5
PPI Cylinder Ileus/urinary retention Medical
CD
39
f
L4-5
PPI Cylinder Rt. L5 NR injury Approach
CA
62
f
L4-5
PPI Cylinder Meralgia paresthetica Approach

Complications: 10/38 Patients 26.3%

OPI = open posterior instrumentation
PPI = percutaneous posterior instrumentation

Updated on: 01/28/16
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Discussion: Direct Lateral Transpsoas Approach
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