Post-operative radiculitis following one or two level anterior lumbar surgery with or without posterior instrumentation

Abstract

Background: Anterior lumbar interbody fusion (ALIF) has evolved as a treatment strategy for a multitude of lumbar spine conditions. To date, two studies have identi ed radiculitis as a complication associated with ALIF procedures, but they do not outline a time to resolution. There have been no reports, of postoperative traction radiculitis in patients following anterior lumbar procedures.Materials and Methods: We retrospectively reviewed seventy patients who underwent anterior lumbar procedures by two surgeons. Using the Farfan ratio we calculated preoperative to postoperative change in disc height. We determined post-operative radiculitis symptoms from review of follow up notes. We also determined the type of graft used in fusion patients.Results: 70 patients were initially identi ed with 12 being excluded. This left 58 to be included in the study. Twenty-one patients (36.2%) developed postoperative radiculitis. There was a moderate to strong correlation with height change and radiculitis (p=0.044). Patients treated with rhBMP-2 had a rate of 36.5% post-operative radiculitis when compared to a rate of 17% for patients fused without rhBMP-2. The number of patients treated without rhBMP-2 were too few to perform statistical analysis, however. All radiculitis resolved by the 3 month follow up appointment. Conclusion:This study shows that there is a 36.2% rate of radiculitis following anterior lumbar procedures. There is a correlation between disc height change and postoperative radiculitis following anterior lumbar procedures. There also appears to be a relationship to the use of rhBMP-2. All radiculitis resolved by 3 months.