Vertebral body fracture after TLIF: a new complication
Philip A. Saville, Jason B. Anari, Harvey E. Smith, Vincent Arlet
March 2016, Volume 25, Issue 1, pp 230 - 238 Case Report Read Full Article 10.1007/s00586-016-4517-1
First Online: 16 March 2016
Background
The transforaminal posterior approach (TLIF) procedure was first described in 1982. Current literature indicates its equality in outcomes for fusion constructs as other anterior-posterior procedures. As a procedure becomes more popular and is more frequently performed the types and number of complications that occur increase. We report on a two case series that underwent TLIF. Both patients had satisfactory postoperative imaging, but presented later with coronal plane vertebral body fractures in the caudal vertebral body of the TLIF construct. We believe the complication may be related to: (a) unrecognized fracture of the endplate during cage impaction; (b) overloading the endplates by maximizing the lordosis achieved by using the reverse jackknife position on a Jackson table; (c) underlying mineral bone disease in patients. As the TLIF procedure increases in popularity, caution should be exercised to avoid the same potential complications.
Purpose
To describe a potential complication with the TLIF procedure.
Study design
Case report.
Patient sample
2.
Outcome measure
Revision surgery.
Methods
Case series.
Results
Caudal vertebral body fracture is a potential complication after TLIF.
Conclusion
TLIF procedures can result in an unstable vertebral body fracture potentially necessitating revision decompression & stabilization. We recommend extra caution in patients with mineral bone disease, as technical errors can be magnified.
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