Predictors of Poor Outcome in Patients Submitted to Minimally Invasive Transforaminal Lumbar Interbody Fusion

• Type: Article in International Scientific Journal
• Date: 2018

Authors

Costa, J (Author) Other; Silva, PS (Author) FMUP; Cunha, M (Author) Other; Almeida, M (Author) Other; Rui Vaz (Author) FMUP; Paulo Pereira (Author) FMUP

Journal

Title: World Neurosurgery

Vol. 119

Pages: 488-493

ISSN: 1878-8750

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 1 Citation

Scopus - 2 Citations

Other information

Authenticus ID: P-00P-39H

DOI: 10.1016/j.wneu.2018.06.207

Abstract (EN): BACKGROUND: Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) has become an increasingly popular method for lumbar arthrodesis. While having similar long-term outcomes when compared with open TLIF, it decreases the amount of intraoperative blood loss and iatrogenic muscle damage, the intensity of postoperative pain, and the duration of hospital stay. However, uncertainty remains about which factors contribute to outcomes in these patients. The purpose of this study was to retrospectively analyze a cohort of patients submitted to MI-TLIF and to identify factors that can be associated with a worse postoperative outcome. METHODS: Clinical records from 283 patients were assessed and, according to Odom's criteria, postoperative clinical outcome at 12 months was classified as excellent, good, fair, and poor. Demographic variables, clinical data, and surgery-related data were analyzed, looking for associations between them and clinical outcome. A binomial logistic regression analysis was then performed to include those associations. RESULTS: The main variables associated with worse prognosis ("poor" class according to Odom's criteria) were a period of sick leave longer than 3 months before the surgery, age younger than 50 years, lytic spondylolisthesis, L5-S1 level, and occurrence of complications. These 5 conditions were included in a logistic regression analysis, and 3 of them were independently associated with poor outcome: operative complications, age younger than 50 years, and sick leave longer than 3 months before surgery. CONCLUSIONS: Younger patients, those on a sick leave for more than 3 months before surgery, or those who suffered surgical complications tended to have less satisfactory results after MI-TLIF.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6