Safety and efficacy of stand-alone anterior lumbar interbody fusion in low-grade L5-S1 isthmic spondylolisthesis.
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BORIS DOI
Date of Publication
January 12, 2022
Publication Type
Article
Division/Institute
Author
Subject(s)
Series
Brain and Spine
ISSN or ISBN (if monograph)
2772-5294
Publisher
Elsevier
Language
English
Publisher DOI
PubMed ID
36248123
Uncontrolled Keywords
Description
Introduction
Surgical management of isthmic spondylolisthesis is controversial and reports on anterior approaches in the literature are scarce.
Research question
To evaluate the safety and efficacy of stand-alone anterior lumbar interbody fusion (ALIF) in patients with symptomatic low-grade L5-S1 isthmic spondylolisthesis.
Material and methods
All adult patients with isthmic spondylolisthesis of the lumbosacral junction treated in a single institution between 2008 and 2019 with stand-alone ALIF were screened. A titan cage was inserted at L5-S1 with vertebral anchoring screws. Prospectively collected surgical, clinical and radiographic data were analyzed retrospectively.
Results
34 patients (19 men, 15 women, mean age 52.5 ± 11.5 years) with a mean follow-up of 3.2 (±2.5) years were analyzed. 91.2% (n = 31) of patients had a low-grade spondylolisthesis and 8.8% (n = 3) grade III according to Meyerding classification. Mean COMI and ODI scores improved significantly from 6.9 (±1.5) and 35.5 (±13.0) to 2.0 (±2.5) and 10.2 (±13.0), respectively after one year, and to 1.7 (±2.5) and 8.2 (±9.6), respectively, after two years. The COMI and ODI scores improved in 86.4% and 80%, respectively, after one year and 92.9% of patients after two years by at least the minimal clinically important difference. No intraoperative complications were recorded. 8.8% (n = 3) of patients needed a reoperation.
Discussion and conclusion
After stand-alone ALIF for symptomatic isthmic spondylolisthesis, the patients improved clinically important after one and two years. Stand-alone ALIF is a safe and effective surgical treatment option for low-grade isthmic spondylolisthesis.
Surgical management of isthmic spondylolisthesis is controversial and reports on anterior approaches in the literature are scarce.
Research question
To evaluate the safety and efficacy of stand-alone anterior lumbar interbody fusion (ALIF) in patients with symptomatic low-grade L5-S1 isthmic spondylolisthesis.
Material and methods
All adult patients with isthmic spondylolisthesis of the lumbosacral junction treated in a single institution between 2008 and 2019 with stand-alone ALIF were screened. A titan cage was inserted at L5-S1 with vertebral anchoring screws. Prospectively collected surgical, clinical and radiographic data were analyzed retrospectively.
Results
34 patients (19 men, 15 women, mean age 52.5 ± 11.5 years) with a mean follow-up of 3.2 (±2.5) years were analyzed. 91.2% (n = 31) of patients had a low-grade spondylolisthesis and 8.8% (n = 3) grade III according to Meyerding classification. Mean COMI and ODI scores improved significantly from 6.9 (±1.5) and 35.5 (±13.0) to 2.0 (±2.5) and 10.2 (±13.0), respectively after one year, and to 1.7 (±2.5) and 8.2 (±9.6), respectively, after two years. The COMI and ODI scores improved in 86.4% and 80%, respectively, after one year and 92.9% of patients after two years by at least the minimal clinically important difference. No intraoperative complications were recorded. 8.8% (n = 3) of patients needed a reoperation.
Discussion and conclusion
After stand-alone ALIF for symptomatic isthmic spondylolisthesis, the patients improved clinically important after one and two years. Stand-alone ALIF is a safe and effective surgical treatment option for low-grade isthmic spondylolisthesis.
File(s)
| File | File Type | Format | Size | License | Publisher/Copright statement | Content | |
|---|---|---|---|---|---|---|---|
| 1-s2.0-S2772529422000029-main.pdf | text | Adobe PDF | 1.32 MB | published |