Complications following single-level interbody fusion procedures: an ACS-NSQIP study

Shillingford, Jamal N.; Laratta, Joseph L.; Lombardi, Joseph M.; Mueller, John D.; Cerpa, Meghan; Reddy, Hemant; Saifi, Comron; Fischer, Charla R.; Lehman, Ronald A.

doi:10.21037/jss.2018.03.19

Cited by 23 publications

(14 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The complication and readmission rates reported in the literature vary between studies. Studies on the National Surgical Quality Improvement Program (NSQIP) database found a 5.51% readmission rate within 30 days [47] and a 4% major complication rate [48], similar to Chan et al, who reported a 3.5% 3-month readmission rate [49]. These rates are relatively similar to the readmission rate calculated for the control group in the current study.…”

Section: Discussionsupporting

confidence: 89%

Economic Analysis of Transforaminal Lumbar Interbody Fusion Surgery Utilizing a Curved Bone Removal Device

Peloza

Millgram

Jacobian

et al. 2021

PharmacoEconomics Open

View full text Add to dashboard Cite

Background Transforaminal lumbar interbody fusion (TLIF) represents a commonly performed spinal procedure that poses a significant financial burden on patients, hospitals and insurers. Reducing these costs, while maintaining efficacy, may be assisted by a new powered endplate preparation device, designed to shorten procedural time while offering positive impacts on other elements that contribute to the cost of care. Objective The aim of the study was to assess and compare the individual cost elements of TLIF procedures with and without the use of the device, to determine whether application of this technology translated into any material procedural savings. Methods The records of 208 single-level TLIF procedures in a single hospital were reviewed. Surgical time, length of hospital stay, blood loss, infection rate, and other parameters were compared for the cases where the device was used (device group; n = 143) and cases which used standard tools (control group; n = 65). The cost per unit of each element was derived from the literature, online resources, and the hospital's financial department. Results The analysis revealed a shorter surgery duration in the device group (23 min, after controlling for procedure year and patient characteristics; statistically significant at p < 0.001) and lower complication and readmission rates (p = 0.67 and p = 0.21, respectively) associated with the use of the device, leading to a statistically significant cost reduction of approximately 2060 US dollars (US$) (p < 0.01). ConclusionThe study suggests that use of the device may lead to a cost reduction and shorter procedure without deteriorating the clinical outcome.

show abstract

Section: Discussionsupporting

confidence: 89%

Economic Analysis of Transforaminal Lumbar Interbody Fusion Surgery Utilizing a Curved Bone Removal Device

Peloza

Millgram

Jacobian

et al. 2021

PharmacoEconomics Open

View full text Add to dashboard Cite

show abstract

“…Good graft bed preparation, quality and quantity of bone graft blocks play important roles in intervertebral fusion. 9 , 10 With the clinical application of polyether ether ketone (PEEK) and nano-materials such as polyether ether ketone (PEEK) with elastic modulus equivalent to vertebral bone and good compatibility with tissue, some scholars use locally excised vertebrae. Plate articular process, vertebral body posterior margin hyperplasia, bone smashing into bone graft to obtain autologous bone particles to avoid iliac bone grafting.…”

Section: Discussionmentioning

confidence: 99%

Effect of bone graft granule volume on postoperative fusion after lumber spinal internal fixation: A retrospective analysis of 82 cases

et al. 2018

View full text Add to dashboard Cite

Objective:To investigate the effect of bone graft volume on postoperative fusion and symptom improvement in lumbar posterior lumbar fusion and internal fixation.Methods:A total of 82 patients receiving pedicle screw rod system internal fixation with Cage bone graft fusion in the First Hospital of Baoding City, Hebei Province were selected and randomly divided into three groups. The excised autologous laminar bones were bitten into different sizes of bone fragments. And different sizes of bone grafts were implanted during the operation. Group-A (n=28) was implanted by bone graft granule with the average volume of 0.2 cm3, Group-B (n=27) was implanted by bone graft granule with the average volume of 0.1 cm3, and Group-C (n=27) was implanted by bone graft granule with the average volume of 0.05 cm3. The bone graft granule volume, clinical effect, bone graft fusion rate and intervertebral space height were compared.Results:The three groups had significantly different bone graft granule volumes (P<0.05), but similar intervertebral bone graft total volumes and Cage heights (P>0.05). In the final follow-up, VAS and ODI of low back pain and two lower limbs pain significantly reduced compared with those before surgery (P<0.05), but the three groups had similar results (P>0.05). The bone graft fusions of Group-B one and two years after surgery were significantly higher than those of Group-A and Group-C, and the values of Group-A exceeded those of Group-C (P<0.05). In the final follow-up, the intervertebral space height change of Group-B was significantly smaller than those of Group-A and Group-C (P<0.05).Conclusion:Size of bone graft granule has no significant effect on postoperative symptoms. However, middle-sized volume bone graft granule (0.1 cm3/granule) showed increased postoperative intervertebral fusion rate and reduced intervertebral space height loss in our study.

show abstract

“…25 Other investigators have examined blood transfusions in this setting and determined that transfusions were not associated with any complication differences between ALIF/direct lateral interbody fusions and PLIF/TLIF procedures. 36…”

Section: Blood Transfusionmentioning

confidence: 99%

Predictors of inpatient admission in the setting of anterior lumbar interbody fusion: a Minimally Invasive Spine Study Group (MISSG) investigation

Parrish

Jenkins

Nolte

et al. 2020

Journal of Neurosurgery: Spine

View full text Add to dashboard Cite

OBJECTIVEWhile the anterior lumbar interbody fusion (ALIF) procedure may be amenable to ambulatory surgery, it has been hypothesized that limitations such as the risk of postoperative ileus and vascular complications have hindered transition of this procedure to the outpatient setting. Identification of independent risk factors predisposing patients to inpatient stays of ≥ 24 hours after ALIF may facilitate better postsurgical outcomes, target modifiable risk factors, and assist in the development of screening tools to transition appropriate patients to the ambulatory surgery center (ASC) setting for this procedure. The purpose of this study was to identify the most relevant risk factors that predispose patients to ≥ 24-hour admission following ALIF.METHODSA prospectively maintained surgical registry was reviewed for patients undergoing single ALIF between May 2006 and December 2019. Demographics, preoperative diagnosis, perioperative variables, and postoperative complications were evaluated according to their relative risk (RR) elevation for an inpatient stay of ≥ 24 hours. A Poisson regression model was used to evaluate predictors of inpatient stays of ≥ 24 hours. Risk factors for inpatient admission of ≥ 24 hours were identified with a stepwise backward regression model.RESULTSA total of 111 patients underwent single-level ALIF (50.9% female and 52.6% male, ≤ 50 years old). Eleven (9.5%) patients were discharged in < 24 hours and 116 remained admitted for ≥ 24 hours. The average inpatient stay was > 2 days (53.7 hours). The most common postoperative complications were fever (body temperature ≥ 100.4°F; n = 4, 3.5%) and blood transfusions (n = 4, 3.5%). Bivariate analysis revealed a preoperative diagnosis of retrolisthesis or lateral listhesis to elevate the RR for an inpatient stay of ≥ 24 hours (RR 1.11, p = 0.001, both diagnoses). Stepwise multivariate analysis demonstrated significant predictors for inpatient stays of ≥ 24 hours to be an operation on L4–5, coexisting degenerative disc disease (DDD) with foraminal stenosis, and herniated nucleus pulposus (RR 1.11, 95% CI 1.03–1.20, p = 0.009, all covariates).CONCLUSIONSThis study provides data regarding the incidence of demographic and perioperative characteristics and postoperative complications as they pertain to patients undergoing single-level ALIF. This preliminary investigation identified the most relevant risk factors to be considered before appropriately transitioning ALIF procedures to the ASC. Further studies of preoperative characteristics are needed to elucidate ideal ASC ALIF patients.

show abstract

Complications following single-level interbody fusion procedures: an ACS-NSQIP study

Cited by 23 publications

References 31 publications

Economic Analysis of Transforaminal Lumbar Interbody Fusion Surgery Utilizing a Curved Bone Removal Device

Economic Analysis of Transforaminal Lumbar Interbody Fusion Surgery Utilizing a Curved Bone Removal Device

Effect of bone graft granule volume on postoperative fusion after lumber spinal internal fixation: A retrospective analysis of 82 cases

Predictors of inpatient admission in the setting of anterior lumbar interbody fusion: a Minimally Invasive Spine Study Group (MISSG) investigation

Contact Info

Product

Resources

About