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Review of Transforaminal Interbody Fusions and Associated Complications. 2008

General Spine

Brandi Hicks, MD,
Greg Petermann, MD, ASSR Member
Lisabeth Bush, MD, Non ASSR Member

Scientific Poster

Exhibit Panels: 1

Purpose

Transforaminal Lumbar Interbody Fusion (TLIF) procedures are becoming more popular for combination external fixation and disc fusion in spinal surgery. Currently these procedures can be done percutaneously with the use of fluoroscopic guidance. We will review how this procedure is performed in the operating room as well as possible complications to monitor post operatively. Complications include infection, CSF leak, aberrant placement of pedicle screws, osteolysis secondary to BMP(bone morphogenetic protein), spondylolisthesis, and graft failure. Prompt diagnosis and awareness of this procedure and it's complications can be invaluable for physicians.

Learning points:
1. Awareness of how percutaneous TLIFs are performed to understand proper screw or graft placement or complications.
2. A comprehensive understanding of multiple complications is needed to provide accurate diagnosis and treatment for the clinician.
3. Review the osteolysis and graft failure findings that can be overlooked on plain films and CT exams.

References

Lewandrowski K, Nanson C, Calderon R. Vertebral osteolysis after posterior interbody lumbar fusion with recombinant human bone morphogenetic protein 2: A report of five cases The Spine Journal 2007; 7:609-614.

Birdwell KH, Anderson PA, Boden SD, et al. JBoneJointSurgAm. What's New in Spine Surgery 2006;88:1897-1907

Shields LBE, Raque GH, Glassman SD, et al. Adverse Effects Associated with High-Dose Recombinant Human Bone Morphogenietic Protein-2 Use in Anterior Cervical Spine Fusion Spine 2006; 31;542-547.

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