Postoperative ileus and gastrointestinal complications following spine surgery: A systematic review of incidence, risk factors, prevention, and treatment

Postoperative Ileus (POI) and other gastrointestinal (GI) complications comprise a significant portion of medical complications seen in spine surgery patients. Experts hypothesize that ileus can occur due to a combination of anesthetic agents, opioid-induced intestinal dysmotility, and decreased mobility. POI and GI complications lead to longer lengths of stay, increased hospital costs, and increased risk of readmission and reoperation in spine surgery patients. A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 59 primary articles met the inclusion criteria. The reported incidence of POI following spine surgery varied significantly from 0.2% to 35.4%, with the middle 50% of studies ranging from 5.1% to 13.6%. Cumulative GI complication rates ranged from 2.1% to 16.2%, with more severe pathologies such as acute colonic pseudo-obstruction (ACPO) having expectedly low incidences of