• World Neurosurg · Jul 2017

    Outcome of Anterior Lumbar Interbody Fusion: a Retrospective Study of Clinical and Radiological Parameters.

    • Harry Pinson, Giorgio Hallaert, Patrick Herregodts, Karel Everaert, Tim Couvreur, Jacques Caemaert, Jean-Pierre Kalala, and Dirk Van Roost.
    • Faculty of Medicine and Medical Sciences, Ghent University, Ghent, Belgium. Electronic address: harry.pinson@ugent.be.
    • World Neurosurg. 2017 Jul 1; 103: 772-779.

    ObjectiveThis study critically evaluates the long-term results of standalone anterior lumbar interbody fusion (ALIF), without use of rhBMP-2, as a therapeutic option for symptomatic patients with degenerative disc disease (DDD). Furthermore, this study intends to identify predictive parameters for anterior lumbar interbody fusion outcome.MethodsA retrospective cohort study with additional telephone interview to obtain missing data was performed. All patients who underwent an L4-L5 or L5-S1 ALIF-procedure, or both, in the period between 2006 and 2011 were identified. The medical files of 123 patients with 154 fusion levels were reviewed. All patients were contacted by telephone to gather supplementary and missing information. Pain and functionality scores (Visual Analogue Scale [VAS] and Oswestry Disability Index [ODI]), radiologic (intervertebral disc height, Modic and Pfirrmann classifications), and different clinical parameters were gathered.ResultsThe mean age of the population at surgery was 46.2 years. Overall, 59 female and 64 male patients were included in the study. The mean VAS score for back and leg pain improved significantly (P < 0.001) with 5 and 4.4 points respectively at 3-year follow-up. Modic-type I changes are associated with a better improvement in VAS score for back pain (P = 0.026), Pfirrmann-grades IV and V and an intervertebral disc height of less than 5 mm are associated with a better improvement in leg pain (respective P-values: 0.045 and 0.033). Overall, 89% of patients would reconsider the surgical intervention.ConclusionsThe ALIF technique is a durable treatment option for patients with DDD. This study suggests different predictive parameters for treatment outcome.Copyright © 2017 Elsevier Inc. All rights reserved.

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