STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To assess for independent risk factors of postoperative ileus (POI) after lateral lumbar interbody fusion (LLIF). SUMMARY OF BACKGROUND DATA: POI is frequently observed in anterior lumbar interbody fusion due to significant bowel manipulation during the approach. LLIF is a minimally invasive approach to the anterior column with reduced bowel manipulation and surgical time. However, there is a paucity of literature on POI after LLIF. METHODS: A retrospective review was performed of records of patients who underwent LLIF from January 2006 to December 2011 at a single institution. Patients with prolonged and recurrent POI were identified by review of hospital stay documentation by a fellowship-trained spine surgeon and a research fellow. POI patients were matched 1:1 to a control cohort without POI. Uni- and multivariate analyses were performed on demographic, comorbidity, surgical indication, medication, and perioperative details to identify independent risk factors for POI. RESULTS: Incidence of prolonged or recurrent POI after LLIF was 7.0% (42/596). Postoperative length of stay was significantly higher for patients with POI (9.9 ± 4.3 d) than control patients (5.6 ± 4.1 d) (P < 0.001). The incidence of ileus in the first 100 LLIF cases (11%) was not significantly higher than in the last 100 LLIF cases (6%) (P = 0.21). Independent risk factors were history of gastroesophageal reflux disease (P < 0.01, adjusted odds ratio [aOR]: 24.31), posterior instrumentation (P = 0.002, aOR: 19.48), and LLIF at L1-L2 (P = 0.04, aOR: 7.82). A history of prior abdominal surgery approached significance as an independent protective factor (P = 0.07, aOR: 0.29). CONCLUSION: There was a relatively high incidence of POI after LLIF. Independent risk factors for POI were a history of gastroesophageal reflux disease, posterior instrumentation, and LLIF at L1-L2. A history of prior abdominal surgery approached significance as an independent protective factor. LEVEL OF EVIDENCE: 3.
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To assess for independent risk factors of postoperative ileus (POI) after lateral lumbar interbody fusion (LLIF). SUMMARY OF BACKGROUND DATA: POI is frequently observed in anterior lumbar interbody fusion due to significant bowel manipulation during the approach. LLIF is a minimally invasive approach to the anterior column with reduced bowel manipulation and surgical time. However, there is a paucity of literature on POI after LLIF. METHODS: A retrospective review was performed of records of patients who underwent LLIF from January 2006 to December 2011 at a single institution. Patients with prolonged and recurrent POI were identified by review of hospital stay documentation by a fellowship-trained spine surgeon and a research fellow. POI patients were matched 1:1 to a control cohort without POI. Uni- and multivariate analyses were performed on demographic, comorbidity, surgical indication, medication, and perioperative details to identify independent risk factors for POI. RESULTS: Incidence of prolonged or recurrent POI after LLIF was 7.0% (42/596). Postoperative length of stay was significantly higher for patients with POI (9.9 ± 4.3 d) than control patients (5.6 ± 4.1 d) (P < 0.001). The incidence of ileus in the first 100 LLIF cases (11%) was not significantly higher than in the last 100 LLIF cases (6%) (P = 0.21). Independent risk factors were history of gastroesophageal reflux disease (P < 0.01, adjusted odds ratio [aOR]: 24.31), posterior instrumentation (P = 0.002, aOR: 19.48), and LLIF at L1-L2 (P = 0.04, aOR: 7.82). A history of prior abdominal surgery approached significance as an independent protective factor (P = 0.07, aOR: 0.29). CONCLUSION: There was a relatively high incidence of POI after LLIF. Independent risk factors for POI were a history of gastroesophageal reflux disease, posterior instrumentation, and LLIF at L1-L2. A history of prior abdominal surgery approached significance as an independent protective factor. LEVEL OF EVIDENCE: 3.
Authors: A Jaber; S Hemmer; R Klotz; T Ferbert; C Hensel; C Eisner; Y M Ryang; P Obid; K Friedrich; W Pepke; M Akbar Journal: Orthopade Date: 2021-06 Impact factor: 1.087
Authors: Paul D Kiely; Lauren E Mount; Jerry Y Du; Joseph T Nguyen; Gil Weitzman; Stavros Memstoudis; Seth A Waldman; Darren R Lebl Journal: Int Orthop Date: 2016-03-10 Impact factor: 3.075
Authors: Tristan B Fried; Khoa Tran; Mark J Lambrechts; Nicholas D D'Antonio; Brian A Karamian; Justin Chu; Jose A Canseco; Alan S Hilibrand; Christopher K Kepler; Alexander R Vaccaro; Gregory D Schroeder Journal: J Craniovertebr Junction Spine Date: 2022-09-14
Authors: Tim O Vilz; Dimitrios Pantelis; Philipp Lingohr; Rolf Fimmers; Anke Esmann; Thomas Randau; Jörg C Kalff; Martin Coenen; Sven Wehner Journal: BMJ Open Date: 2016-07-08 Impact factor: 2.692