Risk Factors for Medical and Surgical Complications After Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion.

backgroundThe prevention of perioperative and postoperative complications is necessary to avoid poor postoperative outcomes and increased costs. Previous investigations have identified risk factors for complications after various spine procedures, but no such study exists in a population solely undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). The purpose of this study is to determine risk factors for the development of complications up to 2 years after MIS TLIF procedures.

methodsPatients who underwent primary, single-level MIS TLIF from 2007 to 2016 were retrospectively reviewed. The incidence of medical and surgical complications up to 2 years postoperatively was determined. Patients were categorized according to demographic, comorbidity, and procedural characteristics. Bivariate Poisson regression with robust error variance was used to determine if an association existed between patient characteristics and complication incidence. A final multivariate model including all patient characteristics as controls was created using backwards, stepwise regression until only those variables with

results390 patients were analyzed. Upon bivariate analysis, age >50 years (

conclusionsDiabetic patients and those who underwent longer operations were at increased risk of medical complications, while younger patients, obese patients and those also with diabetes mellitus were at increased risk of surgical complications up to 2 years after MIS TLIF. Practitioners can use this information to identify patients who require preventative care before their procedure or increased postoperative vigilance and monitoring after single-level MIS TLIF. LEVEL OF EVIDENCE: 3.