Anterior body part interbody fusion (ALIF) is a good surgical modality for several lumbar chronic pathologies. However, a rare and often rumored complication is surgical lymphocele. The goals of this study were to review an oversized consecutive series of patients who underwent ALIF at a high-volume institution, estimate the speed of lymphocele prevalence when ALIF, and investigate the outcomes of patients who developed lymphocele after ALIF. A retrospective assessment of the electronic medical record was conducted, identifying all patients (≥ 18 years old) who received at least a single-level ALIF between 2012 and 2019. Lymphocele was found in postoperative spinal and abdominal imaging and radiology reports. Clinical information was gathered and reported. A total of 1,322 patients received at 1-level of ALIF. Nine hundred and thirty-seven patients (70.9%) obtained postoperative abdomen or lumbar spine imaging, with a lymphocele frequency of 2.1% (20/937 patients). The male/female ratio was 1:1, and the mean ± SD age was 67 ± 10.9 years. Patients with lymphocele were older (66.9 vs 58.9 years, p = 0.006) than those without lymphocele. Furthermore, patients with lymphocele had a higher number of mean levels fused (2.5 vs 1.8, p < 0.001) and were more likely than patients without lymphocele to have undergone ALIF at L2–4 (95.0% vs 66.4%, p = 0.007). Age (OR 1.07, 95% CI 1.01–1.12, p = 0.013), BMI (OR 1.10, 95% CI 1.01–1.18, p = 0.021), and the number of levels fused (OR 1.82, 95% CI 1.05–3.14, p = 0.032) were all found to be independent risk factors for postoperative lymphocele formation in multivariate analysis. Patients with symptomatic lymphocele were treated successfully with IR draining and/or sclerosis therapy, and their radiographic remission was attained. The average length of stay in the hospital was 9.1± 5.2 days. Ten patients (50%) were admitted to a rehab center after surgery; 8 patients (40%) were sent home, 1 (5%) to a skilled nursing facility, and 1 (5%) to a long-term acute care facility.
After ALIF, 2.1% of patients were confirmed with postoperative lymphocele that was radiographically discovered and had risk variables such as increased age, BMI, and the number of levels fused. The majority of patients reported within one month of surgery, symptoms such as stomach discomfort, distension, and/or wound problems. It’s worth noting that 25% of lymphoceles were discovered coincidentally. Patients with symptomatic lymphocele were treated effectively with IR draining and/or sclerosis treatment, and radiographic remission was attained.
Reference:thejns.org/spine/view/journals/j-neurosurg-spine/35/6/article-p722.xml
