Jiaming Cui, Xingyu Guo, Zhaomin Zheng, Hui Liu, Hua Wang, Zemin Li, Jianru Wang


August 2021, Volume 30, Issue 8, pp 2311 - 2322 Original Article Read Full Article 10.1007/s00586-021-06843-y

First Online: 19 April 2021

Purpose

To investigate the perioperative complications of lateral anterior lumbar interbody fusion (LaLIF) surgery.

Methods

The participants were patients who underwent LaLIF surgery for degenerative lumbar diseases between April 2016 and November 2020. The collected data were classified into intraoperative and early-stage postoperative (1 month) complications. Intraoperative complications were subcategorized into nerve root injury, sympathetic chain injury, segmental artery injury, iliolumbar vein injury, peritoneum laceration, temporary psoas injury, endplate damage, and vertebral body fractures. Postoperative complications were subcategorized into surgical site infection, cage migration, cage subsidence and psoas major hematoma.

Results

In the 255 included patients, 39 complications (15.3%) were reported. One patient (0.4%) had residual neurological symptoms (numbness) at the last follow-up after conservative management. The most common complications were temporary psoas injury (3.9%), followed by sympathetic chain injury (2.7%) and endplate damage (2.0%). The most frequent postoperative complication was cage migration (1.6%), followed by cage subsidence (1.2%), and surgical site infection (0.8%).

Conclusion

The complication rates for LaLIF are generally low and comparable to those for conventional OLIF and XLIF that have been reported in other studies. Almost all complications were transient after LaLIF. Severe complications can be avoided by using sufficient muscle relaxant, instruments with the required characteristics and vertical trajectories in multiple steps.


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