Hidden and overall haemorrhage following minimally invasive and open transforaminal lumbar interbody fusion

Yang, Yang; Zhang, Liangming; Liu, Bin; Pang, Mao; Xie, Peigen; Chen, Zihao; Wu, Wenbin; Feng, Feng; Rong, Limin

doi:10.1007/s10195-017-0464-9

Cited by 28 publications

(18 citation statements)

References 17 publications

(20 reference statements)

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“…The main finding in our study revealed that the volume of HBL was 449 ± 191 mL, with a percentage of 44.2% ± 16.6% in the total blood loss, which was agreed with the results from previous studies, such as, Smorgick et al [ 3 ] found that the mean HBL was approximately 40% of total blood loss in posterior spine fusion surgery. Then, using the same calculating method, other author [ 15 , 16 ] reported that the mean HBL after single-level open TLIF was 245.6 ± 97.0 mL, 423 ± 233 mL, being 44.5% ± 12.7%, 66.5% ± 16.1% of the total blood loss, respectively. Our study and previous studies also demonstrated HBL indicating a sizeable amount with total blood loss.…”

Section: Discussionmentioning

confidence: 95%

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Hidden blood loss and the risk factors after posterior lumbar fusion surgery

Lei

et al. 2020

Medicine

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Hidden blood loss (HBL) plays an important role in perioperative rehabilitation of patients underwent posterior lumbar fusion surgery. This study was to calculate the volume of HBL and evaluate the risk factors among patients after posterior lumbar fusion surgery. A retrospective analysis was made on the clinical data of 143 patients underwent posterior lumbar fusion surgery from March 2017 to December 2017. Recording preoperative and postoperative hematocrit to calculate HBL according to Gross formula and analyzing its related factors including age, sex, height, weight, body mass index (BMI), surgery levels, surgical time, surgery types, duration of symptoms, disorder type, specific gravity of urine (SGU), plasma albumin (ALB), glomerular filtration rate (GFR), glucose (GLU), drainage volume, hypertension. Risk factors were further analyzed by multivariate linear regression analysis and t test. Eighty-six males and 57 females, mean age 52.7 ± 11.4 years, mean height 162 ± 7.0, mean weight 61.5 ± 9.4, were included in this study. The HBL was 449 ± 191 mL, with a percentage of 44.2% ± 16.6% in the total perioperative blood loss. Multivariate linear regression analysis revealed that patients with higher BMI ( P = .026), PLIF procedures ( P = .040), and more surgical time ( P = .018) had a greater amount of HBL. Whereas age ( P = 0.713), sex ( P = .276), surgery levels ( P = .921), duration of symptoms ( P = .801), disorder type ( P = .511), SGU ( P = .183), ALB ( P = .478), GFR ( P = .139), GLU ( P = .423), hypertension ( P = .337) were not statistically significant differences with HBL. HBL is a large proportion of total blood loss in patients after posterior lumbar fusion surgery. BMI >24 kg/m 2 , PLIF procedures, and more surgical time are risk factors of HBL. Whereas age, sex, surgery levels, duration of symptoms, disorder type, SGU, ALB, GFR, GLU, hypertension were not associated with HBL.

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Section: Discussionmentioning

confidence: 95%

“…At the same time, there are also many reports concerned about HBL after lumbar poster fusion surgery. [ 3 , 15 – 17 ] However, Up to now, no study focused on the risk factors of HBL after posterior lumbar fusion surgery.…”

Section: Discussionmentioning

confidence: 99%

Hidden blood loss and the risk factors after posterior lumbar fusion surgery

Lei

et al. 2020

Medicine

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“…of Pat.MeanSDNr. of Pat.Zhang et al 2017 [14]146± 1548136± 2559Yang et al 2017 [15]179.0± 20.721141.8± 18.820Tschugg et al 2017 [16]173.4± 7119208.8± 8648Kulkarni et al 2016 [17]204± 32.436177.6± 34.225Hey et al 2015 [18]366.3–25252.5–25Wong et al 2014 [22]123–144225–54Sulaiman et al 2014 [13]375± 1457161± 7.611Singh et al 2014 [23]115.8± 28.233186.0± 31.033Gu et al 2014 [24]195.5± 28.044186.6± 23.438Brodano et al 2013 [25]144–30102–34Seng et al 2013 [26]185± 8.740166± 740Cheng et al 2013 [27]244.6± 73.050278.8± 14.525Parker et al 2013 [30]274–50229–50Adogwa et al 2012 [31]235± 88.3614211± 43.237Wang et al 2012 [32]127± 2542168± 3739Pelton et al 2012 [33]113± 32.3033184.5± 33.9...…”

Section: Resultsmentioning

confidence: 99%

Open versus minimally invasive TLIF: literature review and meta-analysis

Hammad¹,

Wirries²,

Ardeshiri³

et al. 2019

J Orthop Surg Res

100

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Study design This study is a comparative, literature review. Objective The aim of this study is to provide a comparative analysis of open vs. minimally invasive TLIF using a literature review and a meta-analysis. Summary of background data Lumbar interbody fusion is a well-established surgical procedure for treating several spinal disorders. Transforaminal lumbar interbody fusion (TLIF) was initially introduced in the early 1980s. To reduce approach-related morbidity associated with traditional open TLIF (OTLIF), minimally invasive TLIF (MITLIF) was developed. We aimed to provide a comparative analysis of open vs. minimally invasive TLIF using a literature review. Methods We searched the online database PubMed (2005–2017), which yielded an initial 194 studies. We first searched the articles’ abstracts. Based on our inclusion criteria, we excluded 162 studies and included 32 studies: 18 prospective, 13 retrospective, and a single randomized controlled trial. Operative time, blood loss, length of hospital stay, radiation exposure time, complication rate, and pain scores (visual analogue scale, Oswestry Disability Index) for both techniques were recorded and presented as means. We then performed a meta-analysis. Results The meta-analysis for all outcomes showed reduced blood loss ( P < 0.00001) and length of hospital stay ( P < 0.00001) for MITLIF compared with OTLIF, but with increased radiation exposure time with MITLIF ( P < 0.00001). There was no significant difference in operative time between techniques ( P = 0.78). The complication rate was lower with MITLIF (11.3%) vs. OTLIF (14.2%), but not statistically significantly different ( P = 0.05). No significant differences were found in visual analogue scores (back and leg) and Oswestry Disability Index scores between techniques, at the final follow-up. Conclusion MITLIF and OTLIF provide equivalent long-term clinical outcomes. MITLIF had less tissue injury, blood loss, and length of hospital stay. MITLIF is also a safe alternative in obese patients and, in experienced hands, can also be used safely in select cases of spondylodiscitis even with epidural abscess. MITLIF is also a cost-saving procedure associated with reduced hospital and social costs. Long-term studies are required to better evaluate controversial items such as operative time.

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“…The results suggest that the standalone OLIF group achieved better clinical outcomes in the early postoperative term (1 week and 3 months), but the differences disappeared by 2 years. The probable reason is that standalone OLIF does not invade the muscle groups on both sides of the spine and does not cause intra muscular hematoma, leading to better early recovery [18]. The difference disappeared by 2 years once the muscles and hematoma healed in the combined OLIF group.…”

Section: Discussionmentioning

confidence: 99%

“…Until the cancellous bone of the vertebral body is compressed to a certain density and reaches the support cage strength, a stable state is reached and the artificial bone in the cage ensures fusion when the growth of the upper and lower vertebral bodies starts. Micro-fractures in the vertebral body can produce hematoma, and the patient can feel pain and discomfort [18].…”

Section: Discussionmentioning

confidence: 99%

Standalone oblique lateral interbody fusion vs. combined with percutaneous pedicle screw in spondylolisthesis

Sun

et al. 2020

BMC Musculoskelet Disord

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Background: To compare standalone oblique lateral interbody fusion (OLIF) vs. OLIF combined with posterior bilateral percutaneous pedicle screw fixation (OLIF combined) for the treatment of lumbar spondylolisthesis. Methods: This was a retrospective study of patients who underwent standalone OLIF or combined OLIF between 07/2014 and 08/2017 at two hospitals in China. Direct decompressions were not performed. Visual analog scale (VAS), Oswestry Disability Index (ODI), satisfaction rate, anterior/posterior disc heights (DH), foraminal height (FH), foraminal width (FW), cage subsidence, cage retropulsion, fusion rate, and complications were analyzed. All imaging examinations were read independently by two physicians and the mean measurements were used for analysis. Results: A total of 73 patients were included: 32 with standalone OLIF and 41 with combined OLIF. The total complication rate was 25.0% with standalone OLIF and 26.8% with combined OLIF. There were no differences in VAS and ODI scores by 2 years of follow-up, but the scores were better with standalone OLIF at 1 week and 3 months (P < 0.05). PDH and FW was smaller in the combined OLIF group compared with the standalone OLIF group before and after surgery (all P < 0.05). There were significant differences in FH before surgery and at 1 week and 3 months between the two groups (all P < 0.05), but the difference disappeared by 2 years (P = 0.111). Cage subsidence occurred in 7.3% (3/41) and 7.3% (3/41) of the patients at 3 and 24 months, respectively, in the combined OLIF group, compared with 6.3% (2/32) and 15.6% (5/32), respectively, in the standalone OLIF group at the same time points (P = 0.287). There was no cage retropulsion in both groups at 2 years. The fusion rate was 85.4%(35/41) in the combined OLIF group and 84.4% (27/32) in the standalone OLIF group at 3 months(P = 0.669). At 24 months, the fusion rate was 100.0% in the combined OLIF group and 93.8% (30/32) in the standalone OLIF group (P = 0.066).

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Hidden and overall haemorrhage following minimally invasive and open transforaminal lumbar interbody fusion

Cited by 28 publications

References 17 publications

Hidden blood loss and the risk factors after posterior lumbar fusion surgery

Hidden blood loss and the risk factors after posterior lumbar fusion surgery

Open versus minimally invasive TLIF: literature review and meta-analysis

Standalone oblique lateral interbody fusion vs. combined with percutaneous pedicle screw in spondylolisthesis

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