Multivariate Analysis on Risk Factors for Postoperative Ileus After Lateral Lumbar Interbody Fusion

Maaieh, Motasem Al; Du, Jerry Y.; Aichmair, Alexander; Huang, Russel C.; Hughes, Alexander P.; Cammisa, Frank P.; Girardi, Federico P.; Sama, Andrew A.

doi:10.1097/brs.0000000000000238

Cited by 53 publications

(43 citation statements)

References 23 publications

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“…Few studies have focused on the risk factors for POI following scoliosis surgery. Most have reported the incidence of POI following spine surgery, which ranges from 0.6% to 16.7% [8][9][10][11] . The present study is the first to identify the incidence of and risk factors for POI after scoliosis surgery, and it revealed two important findings.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Postoperative Ileus after Scoliosis Surgery

Bureta

Tominaga

Yamamoto

et al. 2018

Spine Surg Relat Res

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Introduction: One complication after scoliosis surgery is ileus; however, few reports have described the frequency of and risk factors for this complication. We conducted a retrospective clinical study with logistic regression analysis to confirm the frequency of and risk factors for ileus after scoliosis surgery. Methods: After a retrospective review of data from patients who underwent surgical correction of spinal deformity from 2009 to 2014, 110 cases (age range, 4-73 yr; median, 14 yr) were included in the study. We defined postoperative ileus (POI) as a surgical complication characterized by decreased intestinal peristalsis and the absence of stool for more than 3 days postoperatively. Various parameters were compared between patients with POI and those without POI. Logistic regression analysis was performed to assess the risk factors associated with ileus; a P value of <0.05 was considered statistically significant. Results: Fifteen of 110 (13.6%) cases developed POI. The median height, weight, operation time, and blood loss volume of the patients with versus without POI were 146 versus 152 cm, 39.0 versus 44.0 kg, 387 versus 359 min, and 1590 versus 1170 g, respectively. There were no significant differences between patients with versus without POI in the measured parameters, with the exception of patient height, bed rest period, and presence of neuromuscular scoliosis. Multiple logistic regression analysis revealed neuromuscular scoliosis as a significant risk factor for POI (odds ratio, 4.21; 95% CI, 1.23-14.40). Conclusions: Our findings indicate a high probability of POI after scoliosis surgery, with an incidence of 13.6%. Neurogenic scoliosis, but not lowest instrumented vertebra or correction rate, was a risk factor for POI after scoliosis surgery. Digestive symptoms should be carefully monitored after surgery, particularly in patients with neuromuscular scoliosis.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Postoperative Ileus after Scoliosis Surgery

Bureta

Tominaga

Yamamoto

et al. 2018

Spine Surg Relat Res

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“…The incidence of prolonged or recurrent postoperative ileus at our institution was approximately 7.0%. A history of gastroesophageal reflux disease, posterior instrumentation as well as LLIF at L1-L2 were found to be independent risk factors [63].…”

Section: Visceral Injurymentioning

confidence: 99%

Lateral Lumbar Interbody Fusion—Outcomes and Complications

Salzmann

Shue

Hughes

2017

Curr Rev Musculoskelet Med

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115

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Purpose of Review Lateral lumbar interbody fusion (LLIF) is a relatively new, minimally invasive technique for interbody fusion. The goal of this review is to provide a general overview of LLIF with a special focus on outcomes and complications. Recent Findings Since the first description of the technique in 2006, the indications for LLIF have expanded and the rate of LLIF procedures performed in the USA has increased. LLIF has several theoretical advantages compared to other approaches including the preservation of the anterior and posterior annular/ligamentous structures, insertion of wide cages resting on the dense apophyseal ring bilaterally, and augmentation of disc height with indirect decompression of neural elements. Favorable long-term outcomes and a reduced risk of visceral/vascular injuries, incidental dural tears, and perioperative infections have been reported. However, approach-related complications such as motor and sensory deficits remain a concern. Summary In well-indicated patients, LLIF can be a safe procedure used for a variety of indications.

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“…2,4,18,19 Spine surgery is unique among orthopaedic procedures because the anterior approach around the peritoneal cavity and into the retroperitoneal space is commonly performed. 2,4,18,19 Spine surgery is unique among orthopaedic procedures because the anterior approach around the peritoneal cavity and into the retroperitoneal space is commonly performed.…”

Section: Ileus In the Orthopaedic Surgery Patientmentioning

confidence: 99%

“…4 Independent risk factors cited in this study included a history of gastroesophageal reflux disease and posterior instrumentation. 4 Independent risk factors cited in this study included a history of gastroesophageal reflux disease and posterior instrumentation.…”

Section: Ileus In the Orthopaedic Surgery Patientmentioning

confidence: 99%

“…1 It is a relatively common postoperative complication following major orthopaedic surgery, occurring in 0.3% to 8.4% of patients depending on the invasiveness and anatomic location of the surgery. [3][4][5][6][7][8][9][10] Although ileus occurs in approximately 15% of patients after abdominal surgical procedures, 1 ileus may also occur in orthopaedic surgery patients who have not been subjected to violation of the peritoneal cavity during their procedures. This complication may lead to substantial morbidity and may be fatal in severe cases.…”

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confidence: 99%

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Paralytic Ileus in the Orthopaedic Patient

Daniels¹,

Ritterman²,

Rubin³

2015

Journal of the American Academy of Orthopaedic Surgeons

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Paralytic ileus is marked by the cessation of bowel motility. This condition is a major clinical concern that may lead to severe patient morbidity in orthopaedic surgery and trauma patients. Ileus most commonly occurs following spinal surgery, traumatic injury, or lower extremity joint reconstruction, but it may also occur following minor orthopaedic procedures. Possible consequences of ileus include abdominal pain, malnutrition, prolonged hospital stay, hospital readmission, bowel perforation, and death. Therapies used in the treatment of ileus include minimization of opioids, early patient mobilization, pharmacologic intervention, and multidisciplinary care. Orthopaedic surgeons should be aware of the clinical signs and symptoms of paralytic ileus and should understand treatment principles of this relatively common adverse event.

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Multivariate Analysis on Risk Factors for Postoperative Ileus After Lateral Lumbar Interbody Fusion

Abstract: 3.

Cited by 53 publications

References 23 publications

Risk Factors for Postoperative Ileus after Scoliosis Surgery

Risk Factors for Postoperative Ileus after Scoliosis Surgery

Lateral Lumbar Interbody Fusion—Outcomes and Complications

Paralytic Ileus in the Orthopaedic Patient

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