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RACS ASC 2025
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Risk Factors for Reoperation after Minimally Invasive Tubular Transforaminal Lumbar Interbody Fusion: A Cohort Study of 756 Patients
Verbal Presentation
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Verbal Presentation

4:45 pm

03 May 2025

Meeting Room C4.3

THE UNFORESEEN PROBLEMS WITH INFORMED CONSENT

Disciplines

Medico-Legal

Talk Description

Institution: Brisbane Clinical Neuroscience Centre - Queensland, Australia

Introduction Despite increasing use, data on complications and reoperation risks in minimally invasive spinal surgery are limited. This study examines short-term (<30 days) and long-term (>30 days) reoperation rates and risk factors following tubular transforaminal lumbar interbody fusion (TLIF) in a high-volume setting. Methods We retrospectively reviewed TLIF cases from 2011-February 2024, performed by 8 neurosurgeons at a single centre. Reoperation rates were analysed, with complications matched to two case-controls undergoing identical TLIF procedures within six months, at comparable levels, and ideally by the same surgeon. Parameters assessed included age, sex, BMI, frailty, comorbidities, patient status, preoperative anticoagulant use, blood results, indications, prior surgery, imaging findings, operative time, length of stay, follow-up, and outcomes. Statistical analysis used Fisher’s exact tests and logistic regression. Results Of 756 patients, 6.6% (n=50) underwent reoperation at a mean follow-up of 1.5 years (SD 1.7 years). Short-term reoperation was predominantly for cage migration and was significantly associated with diabetes and preoperative motor-changes. Long-term reoperation was also mainly for cage migration and was associated with private status, osteoporosis/osteopenia, and previous lumbar surgery (at a different level). Reoperation patients had poorer MacNab outcomes, linked to frailty, diabetes, elevated haemoglobin, static cages, and longer operative times. Conclusion Osteoporosis/osteopenia, diabetes, private insurance, and prior lumbar surgery predict reoperation and poorer outcomes after tubular TLIF. These findings aid risk stratification and inform patient selection and postoperative care.
Presenters
Authors
Authors

Mr Aaron Lerch - , Dr Anthony Chau - , Dr Martin Wood - , Dr Robert Campbell - , Dr Jason Mcmillen - , Dr Jason Papacostas - , Dr Amelia Jardim - , Dr Antonio Tsahtsarlis - , Dr Damian Amato -