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Updated: May 3, 2026
Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
Published on: July 25, 2025
Multivariate analysis on risk factors for postoperative ileus after lateral lumbar interbody fusion
Motasem A Al Maaieh1, Jerry Y Du, Alexander Aichmair
1From the Department of Orthopedic Surgery, Spine and Scoliosis Service, Hospital for Special Surgery, Weill Cornell Medical College, New York City, NY.
Study Design:
Retrospective cohort study.
Objective:
To assess for independent risk factors of postoperative ileus (POI) after lateral lumbar interbody fusion (LLIF).
Summary Of Background Data:
POI is frequently observed in anterior lumbar interbody fusion due to significant bowel manipulation during the approach. LLIF is a minimally invasive approach to the anterior column with reduced bowel manipulation and surgical time. However, there is a paucity of literature on POI after LLIF.
Methods:
A retrospective review was performed of records of patients who underwent LLIF from January 2006 to December 2011 at a single institution. Patients with prolonged and recurrent POI were identified by review of hospital stay documentation by a fellowship-trained spine surgeon and a research fellow. POI patients were matched 1:1 to a control cohort without POI. Uni- and multivariate analyses were performed on demographic, comorbidity, surgical indication, medication, and perioperative details to identify independent risk factors for POI.
Results:
Incidence of prolonged or recurrent POI after LLIF was 7.0% (42/596). Postoperative length of stay was significantly higher for patients with POI (9.9 ± 4.3 d) than control patients (5.6 ± 4.1 d) (P < 0.001). The incidence of ileus in the first 100 LLIF cases (11%) was not significantly higher than in the last 100 LLIF cases (6%) (P = 0.21). Independent risk factors were history of gastroesophageal reflux disease (P < 0.01, adjusted odds ratio [aOR]: 24.31), posterior instrumentation (P = 0.002, aOR: 19.48), and LLIF at L1-L2 (P = 0.04, aOR: 7.82). A history of prior abdominal surgery approached significance as an independent protective factor (P = 0.07, aOR: 0.29).
Conclusion:
There was a relatively high incidence of POI after LLIF. Independent risk factors for POI were a history of gastroesophageal reflux disease, posterior instrumentation, and LLIF at L1-L2. A history of prior abdominal surgery approached significance as an independent protective factor.
Level Of Evidence:
3.
