Choice of approach does not affect clinical and radiologic outcomes

a comparative cohort of patients having anterior lumbar interbody fusion and patients having lateral lumbar interbody fusion at 24 months

Gregory M. Malham*, Rhiannon M. Parker, Carl M. Blecher, Fiona Y. Chow, Kevin A. Seex

*Corresponding author for this work

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

STUDY DESIGN: Retrospective analysis of prospectively collected registry data.

OBJECTIVE: This study aimed to compare the clinical and radiologic outcomes between comparative cohorts of patients having anterior lumbar interbody fusion (ALIF) and patients having lateral lumbar interbody fusion (LLIF).

METHODS: Ninety consecutive patients were treated by a single surgeon with either ALIF (n = 50) or LLIF (n = 40). Inclusion criteria were patients age 45 to 70 years with degenerative disk disease or grade 1 to 2 spondylolisthesis and single-level pathology from L1 to S1. Patient-reported outcome measures included pain (visual analog scale), disability (Oswestry Disability Index [ODI]), and quality of life (Short Form 36 physical component score [PCS] and mental component scores [MCS]). Assessment of fusion and measurement of lordosis and posterior disk height were performed on computed tomography scans.

RESULTS: At 24 months, patients having ALIF had significant improvements in back (64%) and leg (65%) pain and ODI (60%), PCS (44%), and MCS (26%; p < 0.05) scores. Patients having LLIF had significant improvements in back (56%) and leg (57%) pain and ODI (52%), PCS (48%), and MCS (12%; p < 0.05) scores. Fourteen complications occurred in the ALIF group, and in the LLIF group, there were 17 complications (p > 0.05). The fusion rate was 100% for ALIF and 95% for LLIF (p = 0.1948). ALIF added ∼6 degrees of lordosis and 3 mm of height, primarily measured at L5-S1, and LLIF added ∼3 degrees of lordosis and 2 mm of height between L1 to L5. Mean follow-up was 34.1 months.

CONCLUSIONS: In comparative cohorts of patients having ALIF and patients having LLIF at 24 months postoperatively, there were no significant differences in clinical outcomes, complication rates, or fusion rates.

Original languageEnglish
Pages (from-to)472-481
Number of pages10
JournalGlobal Spine Journal
Volume6
Issue number5
DOIs
Publication statusPublished - 1 Aug 2016

Keywords

  • anterior
  • comparison
  • complications
  • fusion
  • lateral
  • lordosis

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