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Risk factors for spinal subdural hematoma after minimally invasive transforaminal lumbar Interbody Fusion (MI-TLIF): a multivariate analysis – Lumbar Fusion

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This article published in BMC Musculoskeletal Disorders discusses spinal subdural hematoma (SSH) as a rare complication after lumbar spine surgery. The study retrospectively analyzed 215 patients who underwent routine MRI following minimal invasive transforaminal lumbar interbody fusion (MI-TLIF) surgery. Out of the patients, 17 (7.9%) were identified with SSH while the remaining 198 had non-SSH. None of the patients experienced serious neurologic symptoms requiring emergency intervention. The study identified hypertension, diabetes, and postoperative anticoagulant therapy as risk factors for postoperative SSH. The authors conclude that SSH after MI-TLIF is not rare, typically does not require emergency procedures, and can be effectively managed with comprehensive treatment. They also emphasize the need for spine surgeons to consider the use of anticoagulants cautiously post-lumbar surgery

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Published article

S: SSH after MI-TLIF is not a rare condition, with generally no requirement of emergency evacuation. Comprehensive anti-symptomatic treatment could achieve satisfactory results. Diabetes mellitus and postoperative anticoagulant therapy are independent risk factors for SSH. Spine surgeons should hold applicability of the use of anticoagulants after lumbar surgery.

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BMC Musculoskelet Disord. 2023 Dec 5;24(1):939. doi: 10.1186/s12891-023-06902-z.ABSTRACTBACKGROUND: Spinal subdural hematoma (SSH) is a rare cause of compression of the neutral elements of the spinal cord. However, little is known about the presentation of acute SSH after lumbar spine surgery. The reason for this may be that symptomatic SSH occurs rarely and is not given,

BMC Musculoskelet Disord. 2023 Dec 5;24(1):939. doi: 10.1186/s12891-023-06902-z.

ABSTRACT

BACKGROUND: Spinal subdural hematoma (SSH) is a rare cause of compression of the neutral elements of the spinal cord. However, little is known about the presentation of acute SSH after lumbar spine surgery. The reason for this may be that symptomatic SSH occurs rarely and is not given enough attention by spine surgeons. Currently, the decision to perform MRI postoperatively is more dependent on surgeon preference; therefore, no high-quality studies have been published. Our team reports our experience in the diagnosis and management of SSH after lumbar decompression and fusion surgery.

METHODS: We retrospectively studied 215 patients who underwent routine MRI following minimal invasive transforaminal lumbar interbody fusion (MI-TLIF) between 2020-01-01 and 2022-06-30. The patients were divided into SSH group (17 cases) and non-SSH group (198 cases) according to the occurrence of SSH. Univariate analysis and multivariate logistic regression analysis were performed to identify relevant risk factors that increase the risk of SSH postoperatively.

RESULTS: None of the patients presented with serious neurologic symptoms, such as lower extremity paralysis or cauda equina syndrome that required emergency hematoma debridement. SSH was found in 17 (7.9%) patients and non-SSH in 198 (92.1%). Factors affecting SSH were presence of hypertension, presence of diabetes and postoperative anticoagulant therapy. The significantly independent risk factor of postoperative SSH were diabetes (P = 0.008, OR: 6.988) and postoperative anticoagulant therapy (P = 0.003, OR: 8.808).

S: SSH after MI-TLIF is not a rare condition, with generally no requirement of emergency evacuation. Comprehensive anti-symptomatic treatment could achieve satisfactory results. Diabetes mellitus and postoperative anticoagulant therapy are independent risk factors for SSH. Spine surgeons should hold applicability of the use of anticoagulants after lumbar surgery.

PMID:38053117 | DOI:10.1186/s12891-023-06902-z

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Risk factors for spinal subdural hematoma after minimally invasive transforaminal lumbar Interbody Fusion (MI-TLIF): a multivariate analysis

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BMC Musculoskelet Disord. 2023 Dec 5;24(1):939. doi: 10.1186/s12891-023-06902-z.ABSTRACTBACKGROUND: Spinal subdural hematoma (SSH) is a rare cause of compression of the neutral elements of the spinal cord. However, little is known about the presentation of acute SSH after lumbar spine surgery. The reason for this may be that symptomatic SSH occurs rarely and is not given

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