ScholarWorks@중앙대학교

초록

Purpose: Postoperative ileus (POI) typically occurs after abdominal surgery but can also af fect patients undergoing spinal surgery via the lateral retroperitoneal approach, such as oblique lumbar interbody fusion (OLIF). Therefore, this study aimed to investigate the incidence and risk factors associated with POI in OLIF. Methods: This retrospective study examined a cohort of 465 patients who underwent OLIF from 2015 to 2023. Patient demographics, comorbidities, pre- and postoperative laborato ry test results, and perioperative status were assessed. General condition of patients was as sessed using the modified frailty index-11 (mFI-11), prognostic nutrition index, and geri atric nutrition risk index. In OLIF, the size and location of the psoas muscle involved in re traction and its relationship with the vertebral body were also investigated. Results: POI occurred in 19 patients (4%). Lower mFI-11 was linked to a higher risk of POI. While psoas muscle size had no significant effect on the risk of POI, the anterior location of the psoas muscle relative to the vertebral body was associated with a higher occurrence of POI. Multivariate logistic regression analysis of POI identified mFI-11 as the most signifi cant risk factor (p = 0.003). Conclusion: This study demonstrated that frailty and nutritional status can influence the occurrence of POI after OLIF. Additionally, bowel manipulation associated with the loca tion of psoas muscle and vertebral body was identified as a risk factor. Proper assessment and improvement in patient frailty and nutritional status before surgery can help predict and prevent the occurrence of postoperative POI.

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