{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T16:43:07Z","timestamp":1764175387584,"version":"3.30.1"},"reference-count":10,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The objective of this study was to identify factors that lead to a prolonged hospital stay or 30-day readmission after minimally invasive surgery (MIS) for transforaminal lumbar interbody fusion (TLIF) at a single institution.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Consecutive patients who underwent MIS TLIF from January 1, 2016, to March 31, 2018, were retrospectively analyzed. Demographic data, including age, sex, ethnicity, smoking status, and body mass index, were collected along with operative details, indications, affected spinal levels, estimated blood loss, and operative duration. The effects of these data were evaluated relative to the hospital length of stay (LOS) and 30-day readmission.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The authors identified 174 consecutive patients who underwent MIS TLIF at 1 or 2 levels from a prospectively collected database. The mean (range) patient age was 64.1 (31\u201381) years, 97 were women (56%), and 77 were men (44%). Of 182 levels fused, 127 were done at L4\u20135 (70%), 32 at L3\u20134 (18%), 13 at L5\u2013S1 (7%), and 10 at L2\u20133 (5%). Patients underwent 166 (95%) single-level procedures and 8 (5%) 2-level procedures. The mean (range) procedural duration, defined as the time from incision to closure, was 164.6 (90\u2013529) minutes. The mean (range) LOS was 1.8 (0\u20138) days. Eleven patients (6%) were readmitted within 30 days; the most frequent causes were urinary retention, constipation, and persistent or contralateral symptoms. Seventeen patients had LOS greater than 3 days. Six of those patients (35%) were identified as widows, widowers, or divorced, and 5 of them lived alone. Six patients with prolonged LOS (35%) required placement in either skilled nursing or acute inpatient rehabilitation. Regression analyses showed living alone (p = 0.04) and diabetes (p = 0.04) as predictors of readmission. Regression analyses revealed female sex (p = 0.03), diabetes (p = 0.03), and multilevel surgery (p = 0.006) as predictors of LOS &gt; 3 days.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Urinary retention, constipation, and persistent radicular symptoms were the leading causes of readmission within 30 days of surgery in this series, which is distinct from data from the American College of Surgeons National Surgical Quality Improvement Program. The inability to discharge a patient home for social reasons led to prolonged inpatient hospital stays. Identifying these risk factors and proactively addressing them could lower readmission rates and decrease LOS among patients undergoing MIS TLIF.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.1.spine22882","type":"journal-article","created":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T12:30:32Z","timestamp":1677846632000},"page":"681-687","source":"Crossref","is-referenced-by-count":2,"title":["Factors associated with readmission after minimally invasive transforaminal lumbar interbody fusion"],"prefix":"10.3171","volume":"38","author":[{"given":"Luis M.","family":"Tumial\u00e1n","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nolan","family":"Weinstein","sequence":"additional","affiliation":[{"name":"University of Arizona College of Medicine\u2013Phoenix, Phoenix, Arizona; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. Harrison","family":"Farber","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shashvat M.","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, HonorHealth Research Institute, Phoenix, Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick F.","family":"Marciano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","article-title":"Conditions with the largest number of adult hospital readmission by payer, 2011","author":"Hines AL","year":"2014","unstructured":"Hines AL, Barrett ML, Jiang J, Steiner CA. Conditions with the largest number of adult hospital readmission by payer, 2011. Statistical Brief No. 172.Agency for Healthcare Research and Quality; 2014. Accessed January 23, 2023.http:\/\/www.hcup-us.ahrq.gov\/reports\/statbriefs\/sb172-Conditions-Readmissions-Payer.pdf"},{"key":"b2","series-title":"Centers for Medicare and Medicaid Services;","article-title":"Hospital readmissions reduction program","year":"2014","unstructured":"Hospital readmissions reduction program. Centers for Medicare and Medicaid Services; 2014.Accessed January 23, 2023.http:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/AcuteInpatientPPS\/Readmissions-Reduction-Program.html"},{"issue":"3","key":"b3","series-title":"Global Spine J","first-page":"220","article-title":"Thirty-day readmission risk factors following single-level transforaminal lumbar interbody fusion (TLIF) for 4992 patients from the ACS-NSQIP database","volume":"7","author":"Garcia RM","year":"2017","unstructured":"Garcia RM, Khanna R, Dahdaleh NS, Cybulski G, Lam S, Smith ZA. Thirty-day readmission risk factors following single-level transforaminal lumbar interbody fusion (TLIF) for 4992 patients from the ACS-NSQIP database. 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Clin Spine Surg. 2019;32(2):46\u201350.30789494"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/38\/6\/article-p681.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/38\/6\/article-p681.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/38\/6\/article-p681.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:11:18Z","timestamp":1733490678000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/38\/6\/article-p681.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,1]]},"references-count":10,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2023.1.spine22882","relation":{},"ISSN":["1547-5654"],"issn-type":[{"type":"print","value":"1547-5654"}],"subject":[],"published":{"date-parts":[[2023,6,1]]}}}