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Comparative Study
. 2017 Nov 1;42(21):E1259-E1265.
doi: 10.1097/BRS.0000000000002145.

Transforaminal Lumbar Interbody Fusion Versus Mini-open Anterior Lumbar Interbody Fusion With Oblique Self-anchored Stand-alone Cages for the Treatment of Lumbar Disc Herniation: A Retrospective Study With 2-year Follow-up

Lei Kuang  1 , Bing Wang, Guohua Lü
Affiliations
Comparative Study

Transforaminal Lumbar Interbody Fusion Versus Mini-open Anterior Lumbar Interbody Fusion With Oblique Self-anchored Stand-alone Cages for the Treatment of Lumbar Disc Herniation: A Retrospective Study With 2-year Follow-up

Lei Kuang et al. Spine (Phila Pa 1976). .

Abstract

Study design: A retrospective study.

Objective: The aim of this study was to evaluate the clinical and radiological outcomes of mini-open ALIF (MO-ALIF) with self-anchored stand-alone cages for the treatment of lumbar disc herniation in comparison with transforaminal lumbar interbody fusion (TLIF).

Summary of background data: Currently, whether ALIF is superior to TLIF for the treatment of lumbar disc herniation remains controversial.

Methods: This study retrospectively reviewed 82 patients who underwent MO-ALIF with self-anchored standalone cages (n = 42) or TLIF (n = 40) for the treatment of lumbar disc herniation between April 2013 and October 2014. Patient demographics, intraoperative parameters, and perioperative complications were collated. Clinical outcomes were evaluated using the visual analog scale (VAS) scoring, the Oswestry Disability Index (ODI) for pain in the leg and back, and radiological outcomes, including fusion, lumbar lordosis (LL), disc height (DH), and cage subsidence were evaluated at each follow-up for up to 2 years.

Results: Patients who underwent TLIF had a significantly higher volume of blood loss (295.2 ± 81.4 vs. 57.0 ± 15.2 mL) and longer surgery time (130.7 ± 45.1 vs. 60.4 ± 20.8 min) than those who had MO-ALIF. Compared with baseline, both groups had significant improvements in the VAS and ODI scores and DH and LL postoperatively, though no significant difference was found between the two groups regarding these indexes. All patients reached solid fusion at the final follow-up in both groups. Three patients (3/42) with three levels (3/50) suffered from cage subsidence in the MO-ALIF group; meanwhile, no cage subsidence occurred in the TLIF group.

Conclusion: MO-ALIF with self-anchored stand-alone cages is a safe and effective treatment of lumbar disc herniation with less surgical trauma and similar clinical and radiological outcomes compared with TLIF.

Level of evidence: 3.

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References

    1. Oppenheimer JH, DeCastro I, McDonnell DE. Minimally invasive spine technology and minimally invasive spine surgery: a historical review. Neurosurg Focus 2009; 27:E9.
    1. Udby PM, Bech-Azeddine R. Clinical outcome of stand-alone ALIF compared to posterior instrumentation for degenerative disc disease: a pilot study and a literature review. Clin Neurol Neurosur 2015; 133:64–69.
    1. Mura PP, Costaglioli M, Piredda M, et al. TLIF for symptomatic disc degeneration: a retrospective study of 100 patients. Eur Spine J 2011; 20:57–60.
    1. Mobbs RJ, Loganathan A, Yeung V, et al. Indications for anterior lumbar interbody fusion. Orthop Surg 2013; 5:153–163.
    1. Than KD, Wang AC, Rahman SU, et al. Complication avoidance and management in anterior lumbar interbody fusion. Neurosurg Focus 2011; 31:E6.

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