• Jiaming Cui, Xingyu Guo, Zhaomin Zheng, Hui Liu, Hua Wang, Zemin Li, and Jianru Wang.
• Department of Spine Surgery, the First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan, 2nd Road, Guangzhou, 510080, Guangdong, China.
• Eur Spine J. 2021 Aug 1; 30 (8): 2311-2322.

PurposeTo investigate the perioperative complications of lateral anterior lumbar interbody fusion (LaLIF) surgery.MethodsThe participants were patients who underwent LaLIF surgery for degenerative lumbar diseases between April 2016 and November 2020. The collected data were classified into intraoperative and early-stage postoperative (1 month) complications. Intraoperative complications were subcategorized into nerve root injury, sympathetic chain injury, segmental artery injury, iliolumbar vein injury, peritoneum laceration, temporary psoas injury, endplate damage, and vertebral body fractures. Postoperative complications were subcategorized into surgical site infection, cage migration, cage subsidence and psoas major hematoma.ResultsIn the 255 included patients, 39 complications (15.3%) were reported. One patient (0.4%) had residual neurological symptoms (numbness) at the last follow-up after conservative management. The most common complications were temporary psoas injury (3.9%), followed by sympathetic chain injury (2.7%) and endplate damage (2.0%). The most frequent postoperative complication was cage migration (1.6%), followed by cage subsidence (1.2%), and surgical site infection (0.8%).ConclusionThe complication rates for LaLIF are generally low and comparable to those for conventional OLIF and XLIF that have been reported in other studies. Almost all complications were transient after LaLIF. Severe complications can be avoided by using sufficient muscle relaxant, instruments with the required characteristics and vertical trajectories in multiple steps.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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