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Moderate sagittal plane deformity patients have similar radiographic and functional outcomes with either anterior or posterior surgery – Lumbar Fusion

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This article compared the functional and radiographic outcomes of two surgical interventions for adult spinal deformity (ASD): anterior lumbar interbody fusion with anterior column realignment (ALIF-ACR) and posterior approach using Smith-Peterson osteotomy with transforaminal lumbar interbody fusion and pedicle screw fixation (TLIF-Schwab2). The study included 61 ASD patients treated surgically and evaluated their spinopelvic radiographic parameters and functional outcomes at 3, 6, and 12 months postsurgery. The results showed that both surgical techniques achieved similar radiographic and functional outcomes at the 1-year follow-up. However, the ALIF-ACR group had a greater degree of correction in lumbar lordosis, while the TLIF-Schwab2 group faced different complications such as dural tears, wound dehiscence, and proximal junctional kyphosis. Further research is needed to optimize patient selection and minimize complications and reoperation rates

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised spine facility in UK

Published article

: Both ALIF-ACR and TLIF-Schwab2 achieved similar radiographic and functional outcomes in ASD patients with moderate sagittal plane deformity at 1-year follow-up. However, the safety profiles of the two techniques differed. Further research is required to optimize patient selection for each surgical approach, aiming to minimize perioperative complications and reoperation rates in this challenging patient population.

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Eur Spine J. 2023 Dec 27. doi: 10.1007/s00586-023-08075-8. Online ahead of print.ABSTRACTPURPOSE: This study aimed to compare the functional and radiographic outcomes of two surgical interventions for adult spinal deformity (ASD): anterior lumbar interbody fusion with anterior column realignment (ALIF-ACR) and posterior approach using Smith-Peterson osteotomy with transforaminal lumbar interbody fusion and pedicle screw fixation,

Eur Spine J. 2023 Dec 27. doi: 10.1007/s00586-023-08075-8. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to compare the functional and radiographic outcomes of two surgical interventions for adult spinal deformity (ASD): anterior lumbar interbody fusion with anterior column realignment (ALIF-ACR) and posterior approach using Smith-Peterson osteotomy with transforaminal lumbar interbody fusion and pedicle screw fixation (TLIF-Schwab2).

METHODS: A retrospective cohort study included 61 ASD patients treated surgically between 2019 and 2020 at a single tertiary orthopedic specialty hospital. Patients were divided into two groups: Group 1 (ALIF-ACR, 29 patients) and Group 2 (TLIF-Schwab2, 32 patients). Spinopelvic radiographic parameters and functional outcomes were evaluated at 3, 6, and 12 months postsurgery.

RESULTS: Perioperative outcomes favored the ALIF-ACR group, with significantly smaller blood loss, shorter hospital stay, and operative time. Radiographic and functional outcomes were similar for both groups; however, the ALIF-ACR group did have a greater degree of correction in lumbar lordosis at 12 months. Complication profiles varied, with the ALIF-ACR group experiencing mostly hardware-related complications, while the TLIF-Schwab2 group faced dural tears, wound dehiscence, and proximal junctional kyphosis. Both groups had similar revision rates.

: Both ALIF-ACR and TLIF-Schwab2 achieved similar radiographic and functional outcomes in ASD patients with moderate sagittal plane deformity at 1-year follow-up. However, the safety profiles of the two techniques differed. Further research is required to optimize patient selection for each surgical approach, aiming to minimize perioperative complications and reoperation rates in this challenging patient population.

PMID:38151636 | DOI:10.1007/s00586-023-08075-8

The London Spine Unit : best recognised spine facility in UK

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Moderate sagittal plane deformity patients have similar radiographic and functional outcomes with either anterior or posterior surgery

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Eur Spine J. 2023 Dec 27. doi: 10.1007/s00586-023-08075-8. Online ahead of print.ABSTRACTPURPOSE: This study aimed to compare the functional and radiographic outcomes of two surgical interventions for adult spinal deformity (ASD): anterior lumbar interbody fusion with anterior column realignment (ALIF-ACR) and posterior approach using Smith-Peterson osteotomy with transforaminal lumbar interbody fusion and pedicle screw fixation
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