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Retrospective analysis of medium-term outcomes following anterior lumbar interbody fusion surgery performed in a tertiary spinal surgical centre – Lumbar Fusion

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The article discusses the use of anterior lumbar interbody fusion (ALIF) as a surgical option for treating spondylolisthesis, degenerative disc disease, and pseudoarthrosis. The study reviewed patient outcomes and complication rates following ALIF surgery over a 5-year period. The results showed that out of 110 patients, 10% experienced complications attributed to the anterior stage of the operation within 90 days, with no patients requiring revision surgery. The study highlights the significant risk of vascular/visceral injury during ALIF and recommends performing the procedure as a dual surgeon operation with a vascular-trained access surgeon. The authors suggest that ALIF is a valid option for revision surgery following failed posterior approaches, with most patients in the study undergoing posterior fixation in combination with anterior fusion

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

Published article

S: Our 90-day complication rate of 10% lies within the 2.6% acute complication and 40% overall complications rates described in previous literature. The risk of vascular/visceral injury is significant (3%) and we recommend that ALIF be performed as a dual surgeon procedure with a vascular-trained access surgeon accompanying the spinal surgeon. ALIF is a valid revision surgical option for failed posterior approaches leading to complications such as pseudoarthrosis. In our sample, 89% of…

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Ann R Coll Surg Engl. 2024 Mar 13. doi: 10.1308/rcsann.2023.0082. Online ahead of print.ABSTRACTINTRODUCTION: Anterior lumbar interbody fusion (ALIF) can treat spondylolisthesis, degenerative disc disease and pseudoarthrosis. This approach facilitates complete discectomy, disc space distraction, indirect decompression of neural foramina and placement of large interbody devices. Several intra- and postoperative complications can be attributed to,

Ann R Coll Surg Engl. 2024 Mar 13. doi: 10.1308/rcsann.2023.0082. Online ahead of print.

ABSTRACT

INTRODUCTION: Anterior lumbar interbody fusion (ALIF) can treat spondylolisthesis, degenerative disc disease and pseudoarthrosis. This approach facilitates complete discectomy, disc space distraction, indirect decompression of neural foramina and placement of large interbody devices. Several intra- and postoperative complications can be attributed to the anterior approach: vascular/visceral injury, hypogastric plexus injury and urogenital consequences. Spine-specific complications include implant migration, graft failure, pseudoarthrosis and persistent symptomology.

METHODS: This retrospective study reviewed patient demographics, medium-term outcomes and complication rates following ALIF surgery performed over a 5-year period. A total of 110 consecutive patients had undergone ALIF surgery at a single tertiary spinal centre. The database was reviewed with a primary outcome of identifying postoperative 90-day complications and whether a revision anterior operation was required after primary ALIF.

RESULTS: No patients required revision anterior operation after their primary ALIF surgery by final follow-up. Out of 110 patients, 11 (10%) recorded a complication attributed to the anterior stage of their operation within 90 days.

S: Our 90-day complication rate of 10% lies within the 2.6% acute complication and 40% overall complications rates described in previous literature. The risk of vascular/visceral injury is significant (3%) and we recommend that ALIF be performed as a dual surgeon procedure with a vascular-trained access surgeon accompanying the spinal surgeon. ALIF is a valid revision surgical option for failed posterior approaches leading to complications such as pseudoarthrosis. In our sample, 89% of patients were managed with posterior fixation to augment the anterior fusion as, biomechanically, this is a proven construct.

PMID:38478070 | DOI:10.1308/rcsann.2023.0082

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Retrospective analysis of medium-term outcomes following anterior lumbar interbody fusion surgery performed in a tertiary spinal surgical centre

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Ann R Coll Surg Engl. 2024 Mar 13. doi: 10.1308/rcsann.2023.0082. Online ahead of print.ABSTRACTINTRODUCTION: Anterior lumbar interbody fusion (ALIF) can treat spondylolisthesis, degenerative disc disease and pseudoarthrosis. This approach facilitates complete discectomy, disc space distraction, indirect decompression of neural foramina and placement of large interbody devices. Several intra- and postoperative complications can be attributed to

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