Results from a prospective study showed the use of anterior lumbar interbody fusion with a vascular-access surgeon and a spine surgeon, using a separate cage and anterior screw plate, provided a reliable construct with high fusion rates and low rates of complications.
The prospective study included 131 patients who underwent anterior lumbar interbody fusion (ALIF) at either L5–S1, L4–5 or both L4–5 and L5–S1 between 2009 and 2012. All of the patients underwent placement of a polyetheretherketone (PEEK) cage filled with rhBMP-2 and a separate anterior titanium plate.
The researchers recorded preoperative clinical data, operative details, postoperative complications, and clinical and radiographic outcomes for all of the patients. Among the clinical outcomes studied were back and leg VAS scores, Oswestry Disability Index and SF-36 Physical and Mental Component Summary scores. The researchers also performed radiographic assessment of fusion using high-definition CT scanning.
One hundred seventeen patients underwent ALIF at L5–S1, nine underwent the procedure at L4–5, and five patients underwent the procedure at both L4–5 and L5–S1. Results showed 19.1% of patients experienced complications following the procedure, with 13% experiencing minor complications and 6.1% experiencing major complications.
The researchers found the mean estimated blood loss per ALIF level was 115 mL, and no significant vascular injuries occurred. Overall, one incidence of retrograde ejaculation occurred, according to the researchers.
No prosthesis failure with the PEEK cage and separate anterior screw-plate was recorded, and back and leg pain improved to 57.2% and 61.8%, respectively.
At 12 months, patients exhibited a 96.9% solid interbody fusion rate, according to the researchers.
Researchers concluded that ALIF, using a separate cage and anterior screw-plate, provides a solid construct with good fusion rates. Complication rates with the procedure are low and provides good clinical outcomes, according to the study.
Disclosure: The authors have no relevant financial disclosures.