Primary single level posterior and transforaminal lumbar interbody fusion perioperative risk profile and risk factor analysis: A retrospective review of 520 consecutive cases at a single academic center.

BACKGROUND AND OBJECTIVES: Posterior and transforaminal lumbar interbody fusion (PLIF and TLIF) are very common spine procedures performed today, primarily for degenerative pathology. There are many people each year who undergo primary single level TLIF or PLIF, therefore the acute risk profile is important information for surgeons. METHODS: A retrospective review was performed on all patients undergoing primary, single level PLIF or TLIF at a tertiary academic medical center. All acute complications within 90-days of surgery, 90-day reoperations, and 30-day readmissions were recorded in addition to baseline patient characteristics and surgical details. Statistical analysis was performed to identify risk factors of postoperative complications. RESULTS: 520 patients were identified, of which 44 complications occurred in 66 patients (12.7%), with anemia requiring transfusion (1.5%) and postoperative delirium (1.5%) being the most common medical complications while nerve injury (1.9%) and surgical site infection (1.3%) were the most frequent surgical complications. There were 26 readmissions (5.1%) within 30-days for any reason, and 15 reoperations (3.2%). Revision of malpositioned screw (1.1%) and surgical site infection washout (0.9%) were the most frequent reoperations. History of transient ischemic attack, and greater operation time were identified as risk factors for any postoperative complication occurring on univariate analysis, while multivariate analysis did not reveal any significant risk factors. CONCLUSION: Primary, single level PLIF or TLIF represents a powerful tool for treating lumbar degenerative disease and is relatively well tolerated, with this study demonstrating an overall 90-day complication rate of 12.7% and 3.2% reoperation rate.