Major complications in extreme lateral interbody fusion access: multicentric study by Italian S.O.L.A.S. group
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ORIGINAL ARTICLE
Major complications in extreme lateral interbody fusion access: multicentric study by Italian S.O.L.A.S. group Andrea Piazzolla1 · Davide Bizzoca1 · Pedro Berjano2 · Massimo Balsano3 · Josip Buric4 · Stefano Carlucci5 · Carlo Formica2 · Matteo Formica6 · Claudio Lamartina2 · Corrado Musso7 · Francesco Tamburrelli8 · Marco Damilano2 · Fulvio Taratara9 · Aldo Sinigaglia2 · Roberto Bassani10 · Massimiliano Neroni11 · Giovanni Casero10 · Alessio Lovi11 · Diego Garbossa12 · Zullo Nicola7 · Biagio Moretti1 Received: 16 March 2020 / Revised: 22 June 2020 / Accepted: 14 July 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The eXtreme Lateral Interbody Fusion (XLIF) approach has gained increasing importance in the last decade. This multicentric retrospective cohort study aims to assess the incidence of major complications in XLIF procedures performed by experienced surgeons and any relationship between the years of experience in XLIF procedures and the surgeon’s rate of severe complications. Methods Nine Italian members of the Society of Lateral Access Surgery (SOLAS) have taken part in this study. Each surgeon has declared how many major complications have been observed during his surgical experience and how they were managed. A major complication was defined as an injury that required reoperation, or as a complication, whose sequelae caused functional limitations to the patient after one year postoperatively. Each surgeon was finally asked about his years of experience in spine surgery and XLIF approach. Pearson correlation test was used to evaluate the association between the surgeon’s years of experience in XLIF and the rate of major complications; a p-value of last than 0.05 was considered significant. Results We observed 14 major complications in 1813 XLIF procedures, performed in 1526 patients. The major complications rate was 0.7722%. Ten complications out of fourteen needed a second surgery. Neither cardiac nor respiratory nor renal complications were observed. No significant correlation was found between the surgeon’s years of experience in the XLIF procedure and the number of major complications observed. Conclusion XLIF revealed a safe and reliable surgical procedure, with a very low rate of major complications, when performed by an expert spine surgeon. Keywords eXtreme lateral interbody fusion (XLIF) · Minimally invasive spine surgery · Complication · Adult scoliosis · Degenerative disc disease · Low-back pain
* Pedro Berjano [email protected] 1
School of Medicine, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic, Trauma and Spine Unit, University of Bari “Aldo Moro”-AOU Policlinico Consorziale, Bari, Italy
2
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
3
Ortopedia e Traumatologia A, Centro Regionale Specializzato in Chirurgia Vertebrale, Azienda Ospedaliera Universitaria Integrata Verona (AOUI), Ospedale Borgo Trento, Verona, Italy
4
Villa Torri Hospital, Bologna, Italy
5
Department of Orthop
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