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Clinical outcome of stand-alone ALIF compared to posterior instrumentation for degenerative disc disease: A pilot study and a literature review
- Source :
- Clinical Neurology and Neurosurgery. 133:64-69
- Publication Year :
- 2015
- Publisher :
- Elsevier BV, 2015.
-
Abstract
- The objective of the article was to: a) present results from a case cohort pilot study comparing stand-alone ALIF and TLIF and, b) review the literature on studies comparing the clinical outcome of stand-alone ALIF with posterior instrumentation including TLIF or PLIF, in patients with disabling low back pain resulting from degenerative disc disease. ALIF surgery has previously been linked with certain high risk complications and unfavorable long term fusion results. Newer studies suggest that stand-alone ALIF can possibly be advantageous compared to other types of posterior instrumented interbody fusion for a selected group of DDD patients. The methods and material consisted of a cohort pilot study of patients, with DDD treated with stand-alone ALIF or TLIF followed by a literature review conducted through a comprehensive PubMed database search of the English literature. Studies comparing stand-alone ALIF with posterior instrumented interbody fusion were selected and reviewed. Results from the pilot study, n = 21, showed a reduced perioperative blood loss, shorter operative time and a trend towards better pain reduction and decreased use of opioid analgesics in patients undergoing stand-alone ALIF compared to posterior instrumented fusion with TLIF. The literature review included three studies, n = 630. All three studies were retrospective cohort studies. The average patient follow-up was 2-years but with heterogeneous selected outcomes. Two of three articles documented significant advantages when using stand-alone ALIF on outcomes such as ODI, VAS, surgical time, blood loss and patient satisfaction. No study found stand-alone ALIF inferior in chosen outcomes including fusion. In conclusion the pilot study and the literature review, finds similar clinical outcomes and fusion rates after stand-alone ALIF and posterior interbody fusion. Stand-alone ALIF was associated with a shorter duration of surgery, less perioperative blood loss and a faster improvement post-operatively. Therefore stand-alone ALIF is a viable and important surgical option, which could be considered first choice as surgical treatment.
- Subjects :
- Adult
medicine.medical_specialty
medicine.medical_treatment
Pilot Projects
Intervertebral Disc Degeneration
Lumbar vertebrae
Degenerative disc disease
Cohort Studies
Patient satisfaction
Outcome Assessment, Health Care
Humans
Medicine
Lumbar Vertebrae
business.industry
Retrospective cohort study
General Medicine
Middle Aged
medicine.disease
Low back pain
Surgery
Spinal Fusion
medicine.anatomical_structure
Spinal fusion
Cohort
Neurology (clinical)
medicine.symptom
business
Cohort study
Subjects
Details
- ISSN :
- 03038467
- Volume :
- 133
- Database :
- OpenAIRE
- Journal :
- Clinical Neurology and Neurosurgery
- Accession number :
- edsair.doi.dedup.....314a80104a025db540c2d57b470ccfee