Prolonged Length of Stay After One- and Two-Level Transforaminal Lumbar Interbody Fusion (TLIF): Risk Factors and...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spine Surgery

Background:

• Limited studies with granular patient data exist on factors influencing prolonged length of stay (LOS) after spine surgery.
• The association between prolonged LOS and functional recovery post-spine surgery remains under-researched.

Purpose of the Study:

• To identify factors associated with prolonged LOS following transforaminal lumbar interbody fusion (TLIF).
• To investigate the impact of prolonged LOS on postoperative complications and functional recovery.

Main Methods:

• Retrospective longitudinal observational cohort study of 576 patients undergoing one- or two-level TLIF.
• Prolonged LOS defined as >85 hours; data collected on demographics, surgical parameters, complications, and patient-reported outcome measures (PROMs).
• Multiple logistic regression used to identify factors associated with prolonged LOS and complications.

Main Results:

• Prolonged LOS was independently associated with older age, lower preoperative hemoglobin, longer operative time, and in-hospital complications.
• Patients with prolonged LOS had significantly higher rates of post-discharge complications, including readmission, surgical site infection, and DVT/PE.
• In a sub-analysis excluding post-discharge complications, prolonged LOS was linked to worse preoperative functional status (ODI, back/leg pain) and poorer postoperative recovery.

Conclusions:

• Prolonged LOS after TLIF is multifactorial, influenced by patient age, preoperative health, and surgical factors.
• Extended LOS increases the risk of both in-hospital and post-discharge complications.
• Prolonged LOS negatively impacts functional recovery, highlighting the importance of optimizing LOS for better patient outcomes.