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Risk factors for postoperative sympathetic chain dysfunction following oblique lateral lumbar interbody fusion: a multivariate analysis

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Abstract

Purpose

Postoperative sympathetic chain dysfunction (PSCD) was a relatively common complication after anterior lumbar interbody fusion due to the manipulation adjacent to the lumbar sympathetic chain (LSC). This study aimed to investigate the incidence of PSCD and identify its related independent risk factors after oblique lateral lumbar interbody fusion (OLIF) surgery.

Methods

PSCD was defined as either of the following in the affected lower limb compared to the contralateral: (1) increase in skin temperature by 1 ºC or more, (2) reduced skin perspiration, (3) limb swelling or skin discoloration. Consecutive patients who underwent OLIF at L4/5 level from February 2018 and May 2022 at a single institution were retrospectively reviewed and divided into two groups: patients with PSCD and patients without PSCD. Binary logistic regression analyses were performed on patients’ demographic, comorbidities, radiological datum and perioperative factors to identify independent risk factors for PSCD.

Results

Twelve (5.7%) of 210 patients experienced PSCD following OLIF surgery. Multivariate logistic regression analysis identified the identification of lumbar dextroscoliosis (OR = 7.907, P = 0.012) and the presence of “tear-drop” psoas (OR = 7.216, P = 0.011) as independent risk factors for the PSCD following OLIF.

Conclusion

This study identified the lumbar dextroscoliosis and the “tear-drop” psoas as independent risk factors for the development of PSCD after OLIF. Spine alignment examination and the morphological identification of psoas major muscle should be highly noticed for the PSCD prevention following OLIF.

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Data availability

Available via the corresponding author's email when the manuscript is received.

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Acknowledgements

We would like to thank AJE (www.aje.com) for English language editing. The authors declare that all methods were performed in accordance with the relevant guidelines and regulations.

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Authors and Affiliations

  1. Department of Spine Surgery, Sichuan Orthopaedic Hospital, No. 132 West First Loop, Chengdu, 610041, People’s Republic of China

    Long Zhao, Wei Hou, Huagang Shi, Wenbin Jiang, Min Cao & Dun Wan

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  1. Long Zhao
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  2. Wei Hou
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  3. Huagang Shi
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  4. Wenbin Jiang
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  5. Min Cao
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  6. Dun Wan
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Correspondence to Dun Wan.

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The study was approved by Ethics Committee of Sichuan Orthopaedic Hospital (No.KY2020-043–01). Informed consent was waived because of its retrospective nature.

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Zhao, L., Hou, W., Shi, H. et al. Risk factors for postoperative sympathetic chain dysfunction following oblique lateral lumbar interbody fusion: a multivariate analysis. Eur Spine J 32, 2319–2325 (2023). https://doi.org/10.1007/s00586-023-07761-x

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  • DOI: https://doi.org/10.1007/s00586-023-07761-x

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