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Anterior Lumbar Interbody Fusion

Ricarda Lechner, David Putzer, Michael Liebensteiner, Christian Bach, Martin Thaler
PURPOSE: Bone graft substitutes have been successfully used in posterolateral lumbar fusion, anterior cervical fusion and animal studies. This study has been conducted to assess the safety and efficacy of β-tricalcium phosphate (β-TCP) in instrumented anterior lumbar interbody fusion (ALIF) procedure. METHODS: In a prospective clinical study, ALIF cages were prefilled with β-TCP and additionally fixated with posterior pedicle screw. Computed tomography (CT) and X-rays were performed one year after surgery...
October 21, 2016: International Orthopaedics
Alexander A Theologis, Gregory M Mundis, Stacie Nguyen, David O Okonkwo, Praveen V Mummaneni, Justin S Smith, Christopher I Shaffrey, Richard Fessler, Shay Bess, Frank Schwab, Bassel G Diebo, Douglas Burton, Robert Hart, Vedat Deviren, Christopher Ames
OBJECTIVE The aim of this study was to evaluate the utility of supplementing long thoracolumbar posterior instrumented fusion (posterior spinal fusion, PSF) with lateral interbody fusion (LIF) of the lumbar/thoracolumbar coronal curve apex in adult spinal deformity (ASD). METHODS Two multicenter databases were evaluated. Adults who had undergone multilevel LIF of the coronal curve apex in addition to PSF with L5-S1 interbody fusion (LS+Apex group) were matched by number of posterior levels fused with patients who had undergone PSF with L5-S1 interbody fusion without LIF (LS-Only group)...
October 21, 2016: Journal of Neurosurgery. Spine
Abolfazl Rahimizadeh, Housain Soufiani, Valliolah Hassani, Ava Rahimizadeh
In this study the authors report the first example of spinal pseudarthrosis in a patient with ochronosis, and they describe the application of posterior-only 360° surgery as an alternative approach to combined anterior-posterior surgery in the management of pseudarthrosis of an ankylosed spine, regardless of its etiology. Spinal involvement in ochronosis produces loss of flexibility and ankylosis of thoracic and lumbar segments. Pseudarthrosis is a serious complication of the diseases that present with ankylosis of the spine...
October 14, 2016: Journal of Neurosurgery. Spine
Kevin Phan, Ya Ruth Huo, Jarred A Hogan, Joshua Xu, Alexander Dunn, Samuel K Cho, Ralph J Mobbs, Patrick McKenna, Trichy Rajagopal, Farhaan Altaf
BACKGROUND: Minimally invasive approaches for the treatment of adult degenerative scoliosis have been increasingly implemented. However, little data exists regarding the safety and complication profiles of minimally invasive lumbar interbody fusion (LIF) for adult degenerative scoliosis. This study aimed to greater understand different minimally invasive surgical approaches for adult degenerative scoliosis with respect to clinical outcomes, changes in radiographic measurements, and complication profiles via meta-analytical techniques...
June 2016: J Spine Surg
Mark J Winder, Shanu Gambhir
The incidence of lumbar fusion for the treatment of various degenerative lumbar spine diseases has increased dramatically over the last twenty years. Many lumbar fusion techniques have been developed and popularized, each with its own advantages and disadvantages. Anterior lumbar interbody fusion (ALIF) initially introduced in the 1930's, has become a common and widely accepted technique for lumbar fusions over the last decade offering several advantages over standard posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF)...
March 2016: J Spine Surg
Md Shah Alam, Kevin Phan, Rezaul Karim, Sharif Ahmed Jonayed, Hasan Khalid Md Munir, Shubhendu Chakraborty, Tashfique Alam
BACKGROUND: Tuberculosis (TB) of the spine is a common site of osseous TB, accounting for 50%-60% of cases. Spinal TB still occurs in both developed and developing countries. The diagnosis of spinal TB is difficult and it commonly presents at an advanced stage. Delays in establishing diagnosis and management result in complications such as spinal cord compression and spinal deformity. METHODS: A total of 582 patients with TB of the cervical, thoracic and lumbar spine with moderate to severe cord compression were studied...
December 2015: J Spine Surg
Kevin Phan, Ralph J Mobbs, Prashanth J Rao
BACKGROUND: One of the proposed advantages of anterior lumbar interbody fusion (ALIF) is restoration of disc height and hence an indirect foraminal height restoration. While this proposed advantage is often quoted in the literature, there are few robust studies demonstrating restoration of foraminal volume. Thus, this study aimed to review the literature and discuss the progression and development of foramen measurement techniques. METHODS: A review of the literature was performed to identify studies which reported foraminal height and dimensions following fusion surgery in cadaveric models or patients...
December 2015: J Spine Surg
Ralph J Mobbs, Kevin Phan, Greg Malham, Kevin Seex, Prashanth J Rao
Degenerative disc and facet joint disease of the lumbar spine is common in the ageing population, and is one of the most frequent causes of disability. Lumbar spondylosis may result in mechanical back pain, radicular and claudicant symptoms, reduced mobility and poor quality of life. Surgical interbody fusion of degenerative levels is an effective treatment option to stabilize the painful motion segment, and may provide indirect decompression of the neural elements, restore lordosis and correct deformity. The surgical options for interbody fusion of the lumbar spine include: posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), minimally invasive transforaminal lumbar interbody fusion (MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF)...
December 2015: J Spine Surg
Kevin Phan, Joshua Xu, Daniel B Scherman, Prashanth J Rao, Ralph J Mobbs
STUDY DESIGN: A systematic review and meta-analysis OBJECTIVE.: To investigate the outcomes of anterior lumber interbody fusion (ALIF) with and without an "access surgeon". SUMMARY OF BACKGROUND DATA: Anterior approaches for spine operations have become increasingly popular but may often involve unfamiliar anatomy and territory for spine surgeons, potentially placing the patient at risk to a greater proportion of approach-related complications. Thus many spine surgeons require or prefer the assistance of an "access surgeon" to perform the exposure...
September 23, 2016: Spine
Daniel J Blizzard, Michael A Gallizzi, Charles Sheets, Benjamin T Smith, Robert E Isaacs, Megan Eure, Christopher R Brown
BACKGROUND: Sagittal balance restoration has been shown to be an important determinant of outcomes in corrective surgery for degenerative scoliosis. Lateral interbody fusion (LIF) is a less-invasive technique which permits the placement of a high lordosis interbody cage without risks associated with traditional anterior or transforaminal interbody techniques. Studies have shown improvement in lumbar lordosis following LIF, but only one other study has assessed sagittal balance in this population...
2016: International Journal of Spine Surgery
Chang Kyu Lee, Dong Ah Shin, Hyoung Ihl Kim, Seong Yi, Yoon Ha, Keung Nyun Kim, Do Heum Yoon
No abstract text is available yet for this article.
September 16, 2016: World Neurosurgery
Kevin Phan, Ralph J Mobbs
Anterior lumbar interbody fusion (ALIF) is one of the surgical procedures for the relief of chronic back pain, radiculopathy and neurogenic claudication in patients with degenerative lumbar spine disease that is refractory to conservative therapy, low-grade spondylolisthesis and pseudo arthrosis. Over the past half century, both the surgical techniques and instrumentation required for ALIF have changed significantly. In particular, the designs of ALIF cage and the materials used have evolved dramatically, the common goal being to improve fusion rates and optimize clinical outcomes...
August 2016: Orthopaedic Surgery
Marjan Alimi, Rodrigo Navarro-Ramirez, Karishma Parikh, Innocent Njoku, Christoph P Hofstetter, Apostolos J Tsiouris, Roger Härtl
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To evaluate the radiographic and clinical outcome of silicate-substituted calcium phosphate (Si-CaP), utilized as a graft substance in spinal fusion procedures. SUMMARY OF BACKGROUND DATA: Specific properties of Si-CaP provide the graft with negative surface charge that can result in a positive effect on the osteoblast activity and neovascularization of the bone. METHODS: This study included those patients who underwent spinal fusion procedures between 2007 and 2011 in which Si-CaP was used as the only bone graft substance...
September 10, 2016: Clinical Spine Surgery
C Fleege, M Arabmotlagh, W Rother, M Rauschmann, M Rickert
INTRODUCTION: For the treatment of isthmic spondylolisthesis two alternative interbody fusion techniques are available, the dorsoventral interposition in ALIF technique and the dorsal access interposition in PLIF technique. Due to the complications of anterior lumbar surgery and in order to avoid a second operation, the dorsoventral fusion technique is becoming uncommon and mainly a pure dorsal supply is performed. The aim of the study was to compare the clinical long-term results of both treatment techniques...
September 2016: Der Orthopäde
Robert J Kroeze, Harm C A Graat, Winand J Pluymakers, Louis N Marting, Martijn van Dijk, Cees F van Dijke, Anton H Vd Klis, Steven J Verberne, Albert J de Gruyter, Olivier P P Temmerman
STUDY DESIGN: Retrospective cohort study comparing intraobserver and interobserver reliability of 3 different radiologic fusion classifications following uninstrumented single-level anterior lumbar interbody fusion. OBJECTIVE OF THE STUDY: The objective of the study was to compare the intraobserver and interobserver reliability of 3 different radiologic spinal fusion scoring systems. SUMMARY OF BACKGROUND DATA: Knowledge regarding radiologic spinal fusion is crucial when studying patients that were treated with lumbar interbody fusion...
August 19, 2016: Clinical Spine Surgery
Dong-Ju Yun, Byeong-Wook Hwang, Hyeong-Seok Oh, Jin-Sung Kim, Sang-Hyeop Jeon, Sang-Ho Lee
BACKGROUND: Percutaneous vertebral augmentation with cement is used as a salvage procedure for failed instrumentation. However, few studies have reported the use of this procedure for failed anterior lumbar fusion in elderly patients with osteoporosis and other complicated diseases who have undergone a previous major operation. METHODS: Between January 2007 and December 2015, the clinical and radiographic results of 8 patients with osteoporosis who showed subsidence and migration of the implant after an initial operation were examined...
August 18, 2016: World Neurosurgery
Gregory D Schroeder, Dessislava Z Markova, John D Koerner, Jeffery A Rihn, Alan S Hilibrand, Alexander R Vaccaro, D Greg Anderson, Christopher K Kepler
OF BACKGROUND DATA: Degenerative changes including Modic Changes (MCs) are commonly observed in patients with chronic low back pain. Although intervertebral disc (IVD) cytokine expression has been shown to be associated with low back pain, the cytokine profile for degenerative IVD with and without MC has not been compared. PURPOSE: To evaluate the potential association between intervertebral disc cytokine expression and MCs. STUDY DESIGN: Laboratory Study METHODS: The IVD from ten patients with Type II MCs and ten patients without MCs who underwent an anterior lumbar interbody and fusion for significant low back pain were collected...
August 4, 2016: Spine Journal: Official Journal of the North American Spine Society
Joshua M Beckman, Berney Vincent, Michael S Park, James B Billys, Robert E Isaacs, Luiz Pimenta, Juan S Uribe
OBJECTIVE Minimally invasive lateral lumbar interbody fusion (LLIF) via the retroperitoneal transpsoas approach is a technically demanding procedure with a multitude of potential complications. A relatively unknown complication is the contralateral psoas hematoma. The authors speculate that injury occurs from segmental vessel injury at the time of contralateral annulus release; however, this is not fully understood. In this multicenter retrospective review, the authors report the incidence of this contralateral complication and its neurological sequelae...
August 5, 2016: Journal of Neurosurgery. Spine
Reid Hoshide, Erica Feldman, Brandon C Gabel, Natalie Taylor, James Gharib, Yu-Po Lee, William Taylor
INTRODUCTION: Minimally invasive lateral lumbar interbody fusion (LLIF) approaches to the lumbar spine reduce patient morbidity compared to anterior or posterior alternatives. This approach, however, decreases direct anatomical visualization, creating the need for highly sensitive and specific neurophysiological monitoring. We seek to determine feasibility in 'transabdominal motor action potential (TaMAP)' monitoring as an assessment for the integrity of the neural elements during lateral-approach surgeries to the lumbar spine...
2016: Curēus
Alan Lackey, Kevin Phan, Ralph Mobbs
A systematic review and meta-analysis was performed to assess the effect of hybrid constructs which involve a total disc arthroplasty (TDA) with stand-alone anterior lumbar interbody fusion (ALIF) versus non-hybrid constructs including multi-level TDA, multi-level transforaminal lumbar interbody fusion (TLIF) with posterior transpedicular fixation or multi-level stand-alone ALIF as a surgical intervention for degenerative disc disease (DDD) in the lumbar spine. Primary outcomes analysed included the Oswestry Disability Index (ODI) and the Visual Analogue Scale (VAS) for back pain...
July 27, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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