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Incidence and risk factors of lumbar plexus injury in patients undergoing oblique lumbar interbody fusion surgery

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Abstract

Purpose

To investigate the incidence and risk factors of lumbar plexus injury (LPI) after oblique lumbar interbody fusion (OLIF) surgery.

Methods

A total of 110 patients who underwent OLIF surgery between January 2017 and January 2021 were retrospectively reviewed. Patients were divided into two groups: the group with LPI (LPI group) and the group without LPI (non-LPI group). The baseline demographic data, surgical variables and radiographic parameters were compared and analyzed between these two groups.

Results

Among all participants, 13 (8.5%) had LPI-related symptoms postoperatively (short-term), and 6 (5.5%) did not fully recover after one year (long-term). Statistically, there were no significant differences in the baseline demographic data, surgery duration, intraoperative blood loss, preoperative diagnosis, surgical procedures used and incision length. Compared with the non-LPI group, patients in the LPI group had a narrower OLIF channel space. In LPI group, the anterior edge of left psoas major muscle overpasses the anterior edge of surgical intervertebral disk (IVD) on axial MRI. Logistic regression analysis revealed that narrow OLIF channel space and the anterior edge of left psoas major muscle overpassing the anterior edge of surgical IVD on axial MRI were independently associated with both short-term and long-term LPI.

Conclusion

Narrow OLIF channel space and the anterior edge of left psoas major muscle overpassing the anterior edge of surgical IVD are significant risk factors of OLIF surgery-related LPI. Surgeons should use preoperative imaging to adequately assess these risk factors to reduce the occurrence of LPI.

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Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

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Authors and Affiliations

  1. Department of Spine Surgery, The Third Hospital of Hebei Medical University, 139Ziqiang Rd, Shijiazhuang, 050051, China

    Yachong Huo, Wenyuan Ding, Dalong Yang, Lei Ma, Ruoyu Zhao & Sidong Yang

  2. Hebei Joint International Research Centre for Spinal Diseases, 139Ziqiang Rd, Shijiazhuang, 050051, China

    Wenyuan Ding & Sidong Yang

  3. School of Chemical Engineering, The University of Queensland, St Lucia 4067, Brisbane, Australia

    Samuel Rudd

Authors
  1. Yachong Huo
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  2. Wenyuan Ding
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  3. Samuel Rudd
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  4. Dalong Yang
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  5. Lei Ma
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Correspondence to Wenyuan Ding or Sidong Yang.

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Huo, Y., Ding, W., Rudd, S. et al. Incidence and risk factors of lumbar plexus injury in patients undergoing oblique lumbar interbody fusion surgery. Eur Spine J 32, 336–344 (2023). https://doi.org/10.1007/s00586-022-07439-w

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  • DOI: https://doi.org/10.1007/s00586-022-07439-w

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