ANALYSIS OF COMPLICATIONS IN PATIENTS UNDERGOING TRANSFORAMINAL LUMBAR INTERBODY FUSION: A CRITICAL EXAMINATION OF SURGICAL INTERVENTIONS FOR LUMBAR CANAL STENOSIS

Rahul Kumar Singh, Priyank Deepak, Chhewang Topgia
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Abstract

Objective: The lumbar spine undergoes degenerative changes with age, leading to lumbar canal stenosis (LCS). Surgical interventions, including transforaminal lumbar interbody fusion (TLIF), become essential when conservative measures fail. Understanding complications associated with TLIF is crucial for informed decision-making and improved patient outcomes. Methods: A study involving 40 LCS patients undergoing TLIF was conducted at Indira Gandhi Medical College, Shimla. Records were retrospectively evaluated for 15 patients (pre-May 2016) and prospectively for 25 patients (May 2016-May 2017). Surgical indications, inclusion/exclusion criteria, preoperative preparation, and TLIF procedures were outlined. Postoperative care and follow-up assessments were detailed. Statistical analysis utilized SPSS 17.0 with a significance level of 0.05. Results: Age and sex distribution demonstrated a significant association (p=0.0049), with a male predominance (57.5%). Occupation analysis revealed 32.5% farmers, 15% laborers, 5% drivers, and 47.5% 'others.' Neurological deficits were present in 75% of cases, while facet joint arthropathy affected 67.5% of patients. Preoperative Oswestry Disability Index indicated severe disability in 62.5% of cases. Conclusion: This study provides critical insights into TLIF complications for LCS, emphasizing male predominance, occupation-related considerations, and significant preoperative disability. Findings contribute to refining surgical protocols, minimizing risks, and optimizing patient safety in TLIF for LCS, essential for advancing spinal surgery standards.
经椎间孔腰椎椎体间融合术患者并发症分析:对腰椎管狭窄症手术治疗的批判性研究
目的:腰椎会随着年龄的增长发生退行性变化,导致腰椎管狭窄(LCS)。当保守治疗无效时,包括经椎间孔腰椎椎体间融合术(TLIF)在内的手术治疗就变得至关重要。了解与 TLIF 相关的并发症对于做出明智决策和改善患者预后至关重要。方法:西姆拉英迪拉-甘地医学院对 40 名接受 TLIF 的腰椎间盘突出症患者进行了研究。对 15 名患者(2016 年 5 月前)的记录进行了回顾性评估,对 25 名患者(2016 年 5 月至 2017 年 5 月)的记录进行了前瞻性评估。概述了手术适应症、纳入/排除标准、术前准备和 TLIF 程序。详细介绍了术后护理和随访评估。统计分析采用 SPSS 17.0,显著性水平为 0.05。结果年龄和性别分布有显著关联(P=0.0049),男性占多数(57.5%)。职业分析显示,农民占 32.5%,工人占 15%,司机占 5%,"其他 "占 47.5%。75%的病例存在神经功能障碍,67.5%的患者患有面关节病。术前 Oswestry 残疾指数显示,62.5% 的病例存在严重残疾。结论:本研究为 LCS 的 TLIF 并发症提供了重要见解,强调了男性占主导地位、与职业相关的考虑因素以及术前严重残疾。研究结果有助于完善 LCS TLIF 的手术方案、降低风险和优化患者安全,这对提高脊柱手术标准至关重要。
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