Anterior lumbar interbody fusion (ALIF) as an possibility for recurrent disc herniations: a scientific assessment and meta-analysis.
J Backbone Surg. 2017 Dec;three(four):587-595
Authors: Phan Ok, Lackey A, Chang N, Ho YT, Abi-Hanna D, Kerferd J, Maharaj MM, Parker RM, Malham GM, Mobbs RJ
Summary
Background: Recurrent intervertebral disc herniation is a comparatively frequent incidence after major discectomy for lumbar intervertebral disc herniation. For recurrent herniations after repeat discectomies, a rising physique of proof means that fusion is efficient in appropriately chosen instances. Theoretically, anterior lumbar interbody fusion (ALIF) permits for complete discectomy, much less trauma to spinal nerves and paraspinal muscle groups and avoidance of the disadvantages of repeat posterior approaches. Nonetheless, ALIF has additionally been related to danger of vascular damage and retrograde ejaculation. This present systematic assessment and meta-analysis goals to evaluate the viability of ALIF as a surgical therapy for recurrent disc herniations.
Strategies: Seven research have been recognized from six digital databases and secondary reference lists. Pre-defined endpoints have been extracted from the included research and meta-analyzed.
Outcomes: For the 181 sufferers from included research, ALIF resulted in vital common enhancements in Oswestry Incapacity Index (ODI) scores (50.49%, P<zero.001), Visible Analogue Scale (VAS) again ache scores (47.85%, P<zero.001) and VAS leg ache scores (37.00%, P<zero.001). Common blood loss was acceptable at 122 mL (P<zero.001) and common operation length was 89 minutes (P<zero.001). Common hospital keep was 5.28 days (P<zero.001). Solely 22 perioperative problems have been reported, with subsidence essentially the most generally reported complication.
Conclusions: Pooled proof means that ALIF is a possible strategy for the therapy of recurrent disc herniations, demonstrating vital enhancements in again and leg ache and minimal problems. These findings warrant additional investigation in massive potential registries and multi-center research.
PMID: 29354736 [PubMed]