Risk factors for spinal subdural hematoma after minimally invasive transforaminal lumbar Interbody Fusion (MI-TLIF): a multivariate analysis
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...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-023-06902-z |
| _version_ | 1797398187710873600 |
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| author | Jiye Lu Wei Zhang Guoqiang Jiang Kefeng Luo Kaiwen Cai Kai Zhang Bin Lu |
| author_facet | Jiye Lu Wei Zhang Guoqiang Jiang Kefeng Luo Kaiwen Cai Kai Zhang Bin Lu |
| author_sort | Jiye Lu |
| collection | DOAJ |
| description | 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). Conclusions 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. |
| first_indexed | 2024-03-09T01:22:09Z |
| format | Article |
| id | doaj.art-11d63619a3014424a9b46d47d291bc60 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-09T01:22:09Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-11d63619a3014424a9b46d47d291bc602023-12-10T12:04:19ZengBMCBMC Musculoskeletal Disorders1471-24742023-12-012411910.1186/s12891-023-06902-zRisk factors for spinal subdural hematoma after minimally invasive transforaminal lumbar Interbody Fusion (MI-TLIF): a multivariate analysisJiye Lu0Wei Zhang1Guoqiang Jiang2Kefeng Luo3Kaiwen Cai4Kai Zhang5Bin Lu6Department of Spinal Surgery, The First Affiliated Hospital of Ningbo UniversityDepartment of Spinal Surgery, The First Affiliated Hospital of Ningbo UniversityDepartment of Spinal Surgery, The First Affiliated Hospital of Ningbo UniversityDepartment of Spinal Surgery, The First Affiliated Hospital of Ningbo UniversityDepartment of Spinal Surgery, The First Affiliated Hospital of Ningbo UniversityDepartment of Spinal Surgery, The First Affiliated Hospital of Ningbo UniversityDepartment of Spinal Surgery, The First Affiliated Hospital of Ningbo UniversityAbstract 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). Conclusions 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.https://doi.org/10.1186/s12891-023-06902-zPostoperative spinal subdural hematomaMI-TLIFLogistic regression analysisPostoperative anticoagulant therapy |
| spellingShingle | Jiye Lu Wei Zhang Guoqiang Jiang Kefeng Luo Kaiwen Cai Kai Zhang Bin Lu Risk factors for spinal subdural hematoma after minimally invasive transforaminal lumbar Interbody Fusion (MI-TLIF): a multivariate analysis BMC Musculoskeletal Disorders Postoperative spinal subdural hematoma MI-TLIF Logistic regression analysis Postoperative anticoagulant therapy |
| title | Risk factors for spinal subdural hematoma after minimally invasive transforaminal lumbar Interbody Fusion (MI-TLIF): a multivariate analysis |
| title_full | Risk factors for spinal subdural hematoma after minimally invasive transforaminal lumbar Interbody Fusion (MI-TLIF): a multivariate analysis |
| title_fullStr | Risk factors for spinal subdural hematoma after minimally invasive transforaminal lumbar Interbody Fusion (MI-TLIF): a multivariate analysis |
| title_full_unstemmed | Risk factors for spinal subdural hematoma after minimally invasive transforaminal lumbar Interbody Fusion (MI-TLIF): a multivariate analysis |
| title_short | Risk factors for spinal subdural hematoma after minimally invasive transforaminal lumbar Interbody Fusion (MI-TLIF): a multivariate analysis |
| title_sort | risk factors for spinal subdural hematoma after minimally invasive transforaminal lumbar interbody fusion mi tlif a multivariate analysis |
| topic | Postoperative spinal subdural hematoma MI-TLIF Logistic regression analysis Postoperative anticoagulant therapy |
| url | https://doi.org/10.1186/s12891-023-06902-z |
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