Thirty day postoperative outcomes following anterior lumbar interbody fusion using the national surgical quality improvement program database

Nicholas B. Abt, Rafael De La Garza-Ramos, Israel O. Olorundare, Brandon A. McCutcheon, Ali Bydon, Jeremy Fogelson, Ahmad Nassr, Mohamad Bydon

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Objective Anterior lumbar interbody fusion (ALIF) is a common procedure used to treat various lumbar degenerative pathologies. The purpose of this study is to describe 30-day postoperative outcomes following ALIF on a national scale.Methods The American College of Surgeons National Surgery Quality Improvement Program (ACS NSQIP) was searched for ALIF patients between 2005 and 2011. The top preoperative diagnoses were determined using ICD-9 codes. All available 30-day complications were grouped as overall composite morbidity and were compared between preoperative diagnosis groups by univariable and multivariable analyses.Results There were a total of 1352 ALIF patients. Overall, 6.73% of patients experienced a postoperative complication. Unplanned reoperations (2.48%), urinary tract infection (1.55%), superficial surgical site infection (1.41%), and sepsis (1.11%) were the most common morbidity events. The morbidity rates for each sub-group were: Intervertebral disc degeneration (4.41%), spondylosis (6.72%), lumbosacral spinal stenosis(8.21%), and spondylolisthesis (8.41%). After extensive adjustment for patient characteristics and preoperative morbidities, multivariable analysis revealed spondylolisthesis (OR=3.29; 95% CI:1.04-10.46) and spinal stenosis (OR=3.76; 95% CI:1.33-10.63) to be associated with significantly higher overall morbidity odds when compared with lumbar disc degeneration. Lumbosacral spondylosis was associated with similar outcomes as degenerative disc disease (OR =1.70; 95% CI:0.48-6.06).Conclusions Diverse postoperative complications need to be managed following ALIF. Patients with spondylolisthesis and spinal stenosis may carry increased 30-day postoperative morbidity profiles in ALIF when compared to those with degenerative disc disease. Prospective studies are needed to better delineate the outcomes of ALIF procedures, particularly in the spondylolisthesis and spinal stenosis patient populations.

Original languageEnglish (US)
Pages (from-to)126-131
Number of pages6
JournalClinical Neurology and Neurosurgery
Volume143
DOIs
StatePublished - Apr 1 2016

Keywords

  • Anterior lumbar interbody fusion
  • National surgical quality improvement project
  • NSQIP
  • Outcomes

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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