Gómez LRA, Chavira RPA, Díaz BS, Chávez LD, Cantú CE, Peńa BAS, Pérez CJA

Language: Spanish
References: 5
Page: 142-146
PDF size: 1587.76 Kb.

ABSTRACT

Introduction: lumbar fusion procedures carry the risk of developing pseudoarthrosis. Despite their prevalence, few studies have characterized the clinical efficacy of life-saving procedures. Clinical case: a 65-year-old male with lumbar pain since undergoing an L5-S1 TLIF (Transforaminal Lumbar Interbody Fusion) procedure four years ago. With claudication and left-sided radicular pain. X-ray revealed adjacent segment disease and L5-S1 pseudoarthrosis. Conservative treatment was initiated without improvement of symptoms. Reconstruction of segmental lordosis by ALIF (Anterior Lumbar Interbody Fusion) is proposed as a rescue procedure. The patient presented improvement in pain and disability Index and evidence of arthrodesis and improvement in segmental spinopelvic parameters at the 3-month followup. Conclusions: using ALIF as a revision surgery for TLIF pseudoarthrosis proved highly effective for arthrodesis, improvement of spinopelvic parameters, and global sagittal alignment.

REFERENCES

1. Etminan M, Girardi FP, Khan SN, Cammisa FP Jr. Revision strategiesfor lumbar pseudarthrosis. Orthop Clin North Am. 2002; 33 (2):381-392. doi: 10.1016/s0030-5898(02)00005-6.

2. Jacob K, Patel M, Prabhu M, Vanjani N, Pawlowski H, Singh K.212. ALIF as a salvage procedure for TLIF pseudarthrosis: a clinicaloutcome study. Spine J. 2022; 22: S112-S113. doi: 10.1016/j.spinee.2022.06.232.

3. Shih CM, Hsu CE, Chen KH, Pan CC, Lee CH. Surgical outcomes ofanterior lumbar interbody fusion in revision lumbar interbody fusionsurgery. J Orthop Surg Res. 2023; 18 (1): 497. doi: 10.1186/s13018-023-03972-6.

4. Safaee MM, Tenorio A, Haddad AF, Wu B, Hu SS, Tay B et al. Anteriorlumbar interbody fusion with cage retrieval for the treatment ofpseudarthrosis after transforaminal lumbar interbody fusion: a singleinstitutioncase series. Oper Neurosurg. 2021; 20 (2): 164-173. doi:10.1093/ons/opaa303.

5. Mobbs RJ, Phan K, Thayaparan GK, Rao PJ. Anterior lumbar interbodyfusion as a salvage technique for pseudarthrosis following posteriorlumbar fusion surgery. Global Spine J. 2016; 6 (1): 14-20. doi:10.1055/s-0035-1555656.