Supine anterior lumbar interbody fusion versus lateral position oblique lumbar interbody fusion at L5-S1: A comparison of two approaches to the lumbosacral junction

Autor: Dean Chou, Shane Burch, Charles M. Eichler, Praveen V. Mummaneni, Chih-Chang Chang, Huibing Ruan, Zhuo Xi
Rok vydání: 2020
Předmět:
Zdroj: Journal of Clinical Neuroscience. 82:134-140
ISSN: 0967-5868
2013-2018
DOI: 10.1016/j.jocn.2020.10.043
Popis: At L5-S1, anterior access can be performed with a supine anterior lumbar interbody fusion (ALIF) or lateral position oblique lumbar interbody fusion (LOLIF). We compared clinical and radiographic features of both approaches.A retrospective study of L5-S1 ALIF and LOLIF patients (2013-2018) by 3 spine surgeons and a vascular surgeon at our hospital was performed. Inclusion criteria were patients undergoing L5-S1 anterior surgery only without other anterior or lateral fusion levels, and data collected were patient demographics, cage parameters, perioperative variables, and radiographic parameters. 58 patients were included (33 ALIF and 25 LOLIF).The average surgical time was 211.94 min for ALIF and 154.86 min for LOLIF (p 0.001). The average blood loss was 214 ml for ALIF and 74 ml for LOLIF (p 0.001). The average number of days to solid food was 2.55 for ALIF and 0.8 for LOLIF (p 0.001). The average anterior L5-S1 disc height increase was 8.52 mm for ALIF and 5.02 mm LOLIF (p = 0.018), and the average posterior L5-S1 disc height increase was 3.34 mm for ALIF and 1.30 mm for LOLIF (p = 0.034). The average L5-S1 segmental lordosis increase was 6.82 degrees for ALIF and 7.63 degrees for LOLIF (p = 0.638).The LOLIF is a feasible option for L5-S1 anterior access compared to ALIF. However, supine ALIF afforded larger cages to be placed, resulting in greater postoperative disc height. There did not appear to be a significant difference in postoperative L5-S1 segmental lordosis between the two approaches.
Databáze: OpenAIRE
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