Abstract
Background The lateral transpsoas approach to the lumbar spine was developed to eliminate the need for an anterior-approach surgeon and retraction of the great vessels and has the potential for shorter operative times. However, the reported complications associated with this approach vary. Questions/purposes We identified the incidence of complications associated with the lateral transpsoas approach to the lumbar spine. Patients and Methods We retrospectively reviewed 45 patients who underwent a lateral transpsoas approach to the spine for various diagnoses between January 1, 2006, and October 31, 2010. The patients' average age was 63.3 years. Sixteen (35.6%) patients had prior lumbar spinal surgery. Twenty-one patients (46.7%) underwent supplemental posterior instrumentation. Minimum followup was 0 months (mean, 11 months; range, 0-34 months). Results Eighteen of the 45 patients (40%) had complications: 10 (22.2%) developed postoperative iliopsoas weakness, three had quadriceps weakness, and one experienced foot drop. Eight patients (17.8%) developed anterior thigh hypoesthesia, which did not fully resolve in seven of the eight patients at an average of 9 months' followup. Three patients had postoperative radiculopathies, one a durotomy, and one died postoperatively from a pulmonary embolism. Conclusions We found a 40% incidence of complications and a nontrivial frequency and severity of postoperative weakness, numbness, and radicular pain in patients who underwent a lateral transpsoas approach to the spine. Given the expanding use of the approach, a thorough understanding of the risks associated with it is essential for patient education, medical decision making, and identifying methods of reducing such complications.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1621-1632 |
| Number of pages | 12 |
| Journal | Clinical orthopaedics and related research |
| Volume | 470 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 2012 |
Funding
One of the authors (AAP) owns stock in Amedica (Salt Lake City, UT), Nocimed (Redwood City, CA), and Cytonics (Jupiter, FL); consults for Amedica, Biomet (Warsaw, IN), and Stryker Spine (Kalamazoo, MI); receives royalties from Amedica; and has received research funding from Stryker Spine through his institution. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. This work was performed at both the University of Utah and Stanford University.
ASJC Scopus subject areas
- Surgery
- Orthopedics and Sports Medicine
