Stand-alone Anterior Lumbar Interbody, Transforaminal Lumbar Interbody, and Anterior/Posterior Fusion: Analysis of Fusion Outcomes and Costs
| Autor: | Jill A. Fattor, Christopher J Kleck, Christopher R. Johnson, Vikas V. Patel, Andriy Noshchenko, Anthony E. Bozzio, Christopher M J Cain, Evalina L. Burger |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pelvic tilt medicine.medical_specialty Radiography Operative Time Posture Blood Loss Surgical Intervertebral Disc Degeneration Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Lumbar Blood loss medicine Humans Orthopedics and Sports Medicine Aged Retrospective Studies 030222 orthopedics Lumbar Vertebrae business.industry Lumbosacral Region Retrospective cohort study Middle Aged medicine.disease Spondylolisthesis Surgery Spinal Fusion Treatment Outcome Elective Surgical Procedures Orthopedic surgery Costs and Cost Analysis Operative time Female business 030217 neurology & neurosurgery |
| Zdroj: | Orthopedics. 41 |
| ISSN: | 1938-2367 0147-7447 |
| DOI: | 10.3928/01477447-20180711-06 |
| Popis: | Fusion outcomes and costs of stand-alone anterior lumbar interbody fusion (ALIF), transforaminal lumbar interbody fusion (TLIF) in association with posterior fusion, and anterior/posterior (A/P) fusion were compared using clinical, radiographic, and billing data. Adult patients with symptomatic 1- or 2-level degenerative disk disease in isolation or in association with a grade 1 or 2 degenerative or lytic spondylolisthesis and canal and/or foraminal stenosis who underwent elective stand-alone ALIF, TLIF, or A/P fusion were compared. The analysis focused primarily on fusion rates and costs and secondarily on radiographic and clinical parameters. One hundred six patients at least 2 years beyond surgery (ALIF, 53; TLIF, 17; A/P fusion, 36) were reviewed. Demographics were similar except for age, with the ALIF group being younger (mean, 37.8 years) than the other groups (TLIF, 53.1 years; A/P fusion, 48.2 years). There were no differences between the groups in fusion rates or outcomes as assessed by the Numeric Rating Scale. Compared with the other 2 groups, the ALIF group had a significantly shorter operative time, less blood loss, and a shorter stay ( P P P P =.001) favoring ALIF and A/P fusion over TLIF. Stand-alone ALIF should be considered in the management of patients with 1- or 2-level lumbar degenerative disk disease for which the pathology can be addressed adequately via this approach. [ Orthopedics . 2018; 41(5):e655–e662.] |
| Databáze: | OpenAIRE |
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