medigraphic.com
ISSN 2992-7749 (Electronic)
ISSN 2992-7897 (Print)
Órgano Oficial de difusión científica de la Asociación Mexicana de Cirujanos de Columna A. C.

2025, Number 4

<< Back Next >>

Cir Columna 2025; 3 (4)

Safety and efficacy of ALIF stand alone: a retrospective case series of 55 levels

Valdez-Aguilar JE, Sauri-Barraza JC, Callejas-Ponce E, Garibay-Infante LA, Pérez-Ruiz JD, Carral-Robles-León E, Bañuelos-Aluzzi CE

Language: Spanish
References: 17
Page: 285-289
PDF size: 198.32 Kb.


ABSTRACT

Introduction: anterior lumbar interbody fusion (ALIF) is a procedure for the treatment of lumbar degenerative disease with a recent increase in its use, either alone or as an augmentation to a posterior arthrodesis. The use of ALIF stand-alone for the treatment of lumbar degenerative disease with or without low-grade spondylolisthesis is still controversial. Objective: to evaluate the safety, efficacy, radiographic and clinical results in patients undergoing ALIF stand-alone, without the need for posterior fixation. Material and methods: a search was carried out in the electronic record of a single team in a tertiary hospital, for patients undergoing ALIF from 2019 to 2024. The data included were demographics, clinical status, imaging and complications. Fusion success was determined by imagenologic study after 24 weeks. The clinical evolution was determined by the axial and radicular visual analogue scale (VAS), in addition to the Oswestry Disability Index (ODI). Results: thirty-eight patients were included. Seven patients (18%) had previous lumbar surgery, five (13.1%) had low-grade spondylolisthesis. The fusion rate was 96.36%. The average presurgical axial VAS score was 7.31 and postsurgical 2.93 (p < 0.05), radicular 5.37 presurgical and 1.56 postsurgical (p < 0.05), average ODI presurgical was 2.11 and 6.11 postsurgical; 13.1% presented some complication associated with surgery, without compromising the patient's evolution. Conclusions: ALIF stand alone, even in cases with low grade spondylolisthesis, its a safe option and achieves a high fusion rate.


REFERENCES

  1. Mobbs RJ, Phan K, Daly D, Rao PJ, Lennox A. Approach-related complications of anterior lumbar interbody fusion: results of a combined spine and vascular surgical team. Global Spine J. 2016; 6: 147-154.

  2. Capener N. Spondylolisthesis. Br J Surg. 1932; 19: 374-386.

  3. Ito H, Tsuchiya J, Asami G. A new radical operation for Pott's disease. Report of ten cases. J Bone Joint Surg Br. 1934; 16: 499-515.

  4. Pradhan BB, Nassar JA, Delamarter RB, Wang JC. Single-level lumbar spine fusion: a comparison of anterior and posterior approaches. J Spinal Disord Tech. 2002; 15 (5): 355-361.

  5. Van Akkerveeken PF. Anterior lumbar interbody fusion. Acta Orthop Scand Suppl. 1993; 251: 105-107.

  6. Mummaneni PV, Haid RW, Rodts GE. Lumbar interbody fusion: state-of-the-art technical advances. Invited submission from the Joint Section Meeting on disorders of the spine and peripheral nerves, March 2004. J Neurosurg Spine. 2004; 1: 24-30.

  7. Wang JC, Mummaneni PV, Haid RW. Current treatment strategies for the painful lumbar motion segment: posterolateral fusion versus interbody fusion. Spine. 2005; 30: S33-S43.

  8. Burkus JK, Gornet MF, Schuler TC, Kleeman TJ, Zdeblick TA. Six-year outcomes of anterior lumbar interbody arthrodesis with use of interbody fusion cages and recombinant human bone morphogenetic protein-2. J Bone Joint Surg Am. 2009; 91: 1181-1189.

  9. Shen FH, Samartzis D, Khanna AJ, Anderson DG. Minimally invasive techniques for lumbar interbody fusions. Orthop Clin North Am. 2007; 38: 373-386.

  10. Kim JS, Kim DH, Lee SH, Park CK, Hwang JH, Cheh G, et al. Comparison study of the instrumented circumferential fusion with instrumented anterior lumbar interbody fusion as a surgical procedure for adult low-grade isthmic spondylolisthesis. World Neurosurg. 2010; 73: 565-571.

  11. Mobbs RJ, Loganathan A, Yeung V, Rao PJ. Indications for anterior lumbar interbody fusion. Orthop Surg. 2013; 5: 153-163.

  12. Rao PJ, Phan K, Giang G, Maharaj MM, Phan S, Mobbs RJ. Subsidence following anterior lumbar interbody fusion (ALIF): a prospective study. J Spine Surg. 2017; 3: 168-175. doi: 10.21037/jss.2017.05.03.

  13. Laiwalla AN, Chang RN, Harary M, Salek SA, Richards HG, Brara HS, et al. Primary anterior lumbar interbody fusion, with and without posterior instrumentation: a 1,377-patient cohort from a multicenter spine registry. Spine J. 2024; 24: 496-505.

  14. Udby PM, Bech-Azeddine R. Clinical outcome of stand-alone ALIF compared to posterior instrumentation for degenerative disc disease: a pilot study and a literature review. Clin Neurol Neurosurg. 2015; 133: 64-69.

  15. Kashlan O, Frerich JM, Malcolm JG, Gary MF, Rodts GE, Refai D. Safety profile and radiographic and clinical outcomes of stand-alone 2-level anterior lumbar interbody fusion: a case series of 41 consecutive patients. Cureus. 2020; 12: e11684.

  16. Patil ND, El Ghait HA, Boehm C, Boehm H. Evaluation of spinal fusion in thoracic and thoracolumbar spine on standard X-rays: a new grading system for spinal interbody fusion. Global Spine J. 2022; 12: 1481-1494.

  17. Hofstetter CP, Hofer AS, Levi AD. Exploratory meta-analysis on dose-related efficacy and morbidity of bone morphogenetic protein in spinal arthrodesis surgery. J Neurosurg Spine. 2016; 24: 457-475.




2020     |     www.medigraphic.com