TY  - BOOK
AU  - McGowan, Jason
AU  - Mueller, Kyle
TI  - Evaluation of retraction time as a predictor of postoperative motor dysfunction after minimally invasive transpsoas interbody fusion at L4-L5
SN  - 0967-5868
PY  - 2019///
KW  - *Femoral Nerve/in [Injuries]
KW  - *Muscle Weakness/et [Etiology]
KW  - *Postoperative Complications/et [Etiology]
KW  - *Spinal Fusion/ae [Adverse Effects]
KW  - Adult
KW  - Aged
KW  - Female
KW  - Humans
KW  - Lumbar Vertebrae/su [Surgery]
KW  - Male
KW  - Middle Aged
KW  - Muscle Weakness/ep [Epidemiology]
KW  - Postoperative Complications/ep [Epidemiology]
KW  - Retrospective Studies
KW  - Spinal Fusion/mt [Methods]
KW  - MedStar Washington Hospital Center
KW  - Neurosurgery
KW  - Journal Article
N2  - BACKGROUND: Complications associated with the lateral lumbar transpsoas approach largely comprise various nerve-related syndromes particularly at L4-5. Quadriceps weakness can occur from stretch injury to the femoral nerve during retraction; CONCLUSION: The results of this study suggest that longer retraction time (within a range of 14-51min) did not correlate with a greater risk of postoperative neuropathic quadriceps muscle dysfunction for lateral lumbar interbody fusions performed at L4-5. Other factors may contribute to postoperative neurologic dysfunction regardless of RT. Motor deficits resolved quickly after surgery; Copyright (c) 2018 Elsevier Ltd. All rights reserved; METHODS: A retrospective review of a prospectively collected database at a single institution was reviewed over a two-year period (March 2014-2016) for a single surgeon. Twenty-six patients undergoing single level LLIF at L4-5 were identified. Pre- and postoperative data collection obtained included motor function grading (0-5/5) with a minimum of 3-month postoperative follow-up. Intraoperative data collection included retraction time (RT) defined as the time the retraction system was affixed to the spine and expanded to the time of closure and removal. Two-Tailed T-Test was used to determine clinical significance; OBJECTIVE: The purpose of this study is to evaluate the role of retraction time in the development of postoperative neuropathic motor weakness at the L4-5 level; RESULTS: 50% of patients had leg weakness after surgery (13/26). All postoperative motor deficits were at least antigravity strength (>3/5) and all deficits resolved. The mean RT for the motor dysfunction cohort was 29min (14-51) compared to 27.5min for the cohort without postoperative weakness (19-37) (p=0.685)
UR  - https://dx.doi.org/10.1016/j.jocn.2018.10.108
ER  -