Andrea Piazzolla1, Davide Bizzoca1, Pedro Berjano2, Massimo Balsano3, Josip Buric4, Stefano Carlucci5, Carlo Formica6, Matteo Formica7, Claudio Lamartina6, Corrado Musso8, Francesco Tamburrelli9, Marco Damilano6, Fulvio Tartara10, Aldo Sinigaglia6, Roberto Bassani11, Massimiliano Neroni12, Giovanni Casero11, Alessio Lovi12, Diego Garbossa13, Zullo Nicola8, Biagio Moretti1. 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. pberjano@gmail.com. 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 Orthopaedics and Traumatology, SS Annunziata, Taranto, Italy. 6. IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. 7. Clinica Ortopedica, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genova, Italy. 8. Unità Operativa Chirurgia della Colonna 2, Humanitas Gavazzeni, Bergamo, Italy. 9. Department of Orthopedic Science and Traumatology. Spine Surgery Division, Catholic University Rome, Rome, Italy. 10. Azienda Ospedaliera "Istituti Ospitalieri Di Cremona"-U.O.C. Di Neurochirurgia, Cremona, Italy. 11. Salvator Mundi International Hospital, Rome, Italy. 12. GSpine 3, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. 13. Clinica Neurochirurgica, Città della Salute e della Scienza, "Molinette", Turin, Italy.
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.
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.
Authors: Giuseppe Costanzo; Carmine Zoccali; Philip Maykowski; Christina M Walter; Jesse Skoch; Ali A Baaj Journal: Eur Spine J Date: 2014-09-13 Impact factor: 3.134
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