[Anterior lumbar interbody fusion (ALIF) using a cage with stabilization].

AIM The authors have conducted a prospective observational study to evaluate the clinical and radiological outcome and complications associated with anterior lumbar interbody fusion (ALIF) using a cage with stabilization. MATERIALS AND METHODS Eighteen patients ranged in age from 36 to 77 years (mean 53 years) who had undergone ALIF were prospectively evaluated. Clinical outcome was graded using a modified Prolo scale (economic, pain, medication) and radiological outcome was recorded (X-rays). RESULTS Based on Prolo scale scores, excellent or good outcomes were achieved in 61 % of these patients (75 % mono-segmental degenerative disc disease: n = 8; and 50 % after failed-back surgery syndrome: n = 10). The mean follow-up was 14 months (from 12 to 18 months) after surgery. Postoperative X-rays demonstrated solid arthrodesis for 12 (66 %) of the 18 patients. Complications requiring repeated surgery included one case of postoperative peritonitis without infection of the cage. We found one deep-vein thrombosis. There were four cases with postoperative meralgia paresthetica. On routine follow-up radiography one cage was found to be dislocated (2 mm) and in one case we found two broken screws. CONCLUSION The ALIF cage with stabilization is one possible therapy option for treatment of mono-segmental degenerative disc disease and failed-back surgery after unsuccessful conservative therapy. However, the clinical results should be interpreted with caution.

[1]  J. Dimick,et al.  730 The Use of Spine Fusion in the United States , 2004 .

[2]  T. J. Lim,et al.  A biomechanical comparison of supplementary posterior translaminar facet and transfacetopedicular screw fixation after anterior lumbar interbody fusion. , 2004, Journal of neurosurgery. Spine.

[3]  C. Dickman,et al.  Anterior Lumbar Interbody Fusion for Treatment of Failed Back Surgery Syndrome: An Outcome Analysis , 2004, Neurosurgery.

[4]  Alf Nachemson,et al.  Spinal-fusion surgery - the case for restraint. , 2004, The New England journal of medicine.

[5]  U. Vieweg Möglichkeiten zur kostenoptimierten Implantatauswahl in der Wirbelsäulenchirurgie , 2003 .

[6]  S. Blumenthal,et al.  Intervertebral cages for degenerative spinal diseases. , 2003, The spine journal : official journal of the North American Spine Society.

[7]  B. Kirking,et al.  Load Sharing and Kinematics of Threaded Cages for Lumbar Interbody Fusion , 2003, Clinical orthopaedics and related research.

[8]  H. Mayer,et al.  Microsurgical Anterior Approaches to the Lumbar Spine for Interbody Fusion and Total Disc Replacement , 2002, Neurosurgery.

[9]  C. D. Ray,et al.  Symposium: A Critical Discrepancy—A Criteria of Successful Arthrodesis Following Interbody Spinal Fusions , 2001, Spine.

[10]  K. Kaneda,et al.  In vitro biomechanical investigation of the stability and stress-shielding effect of lumbar interbody fusion devices. , 2000, Journal of neurosurgery.

[11]  L. Nolte,et al.  A Comparative Biomechanical Investigation of Anterior Lumbar Interbody Cages: Central and Bilateral Approaches* , 2000, The Journal of bone and joint surgery. American volume.

[12]  H. Mayer The ALIF concept , 2000, European Spine Journal.

[13]  M. Aebi,et al.  Cages: designs and concepts , 2000, European Spine Journal.

[14]  R. Mulholland Cages: outcome and complications , 2000, European Spine Journal.

[15]  M. Aebi,et al.  Biomechanical stability of five stand-alone anterior lumbar interbody fusion constructs , 2000, European Spine Journal.

[16]  J. Gibson,et al.  The Cochrane review of surgery for lumbar disc prolapse and degenerative lumbar spondylosis. , 1999, Spine.

[17]  V. Rajaraman,et al.  Visceral and vascular complications resulting from anterior lumbar interbody fusion. , 1999, Journal of neurosurgery.

[18]  P. McAfee Interbody fusion cages in reconstructive operations on the spine. , 1999, The Journal of bone and joint surgery. American volume.

[19]  S. L. Griffith,et al.  The Bagby and Kuslich Method of Lumbar Interbody Fusion: History, Techniques, and 2‐Year Follow‐up Results of a United States Prospective, Multicenter Trial , 1998, Spine.

[20]  R. Fraser,et al.  Anterior Lumbar Interbody Fusion: A Minimum 10‐Year Follow‐Up , 1997 .

[21]  C D Ray,et al.  Threaded Titanium Cages for Lumbar Interbody Fusions , 1997, Spine.

[22]  D. Capen,et al.  Assessment of pseudarthrosis in pedicle screw fusion: a prospective study comparing plain radiographs, flexion/extension radiographs, CT scanning, and bone scintigraphy with operative findings. , 1996, Journal of spinal disorders.

[23]  A. Tencer,et al.  Biomechanical Properties of Threaded Inserts for Lumbar Interbody Spinal Fusion , 1995, Spine.

[24]  R. Fraser,et al.  Anterior lumbar fusion. A comparison of noncompensation patients with compensation patients. , 1994, Clinical orthopaedics and related research.

[25]  M. Linson,et al.  Anterior and Combined Anteroposterior Fusion for Lumbar Disc Pain A Preliminary Study , 1991, Spine.

[26]  G. Bagby Arthrodesis by the distraction-compression method using a stainless steel implant. , 1988, Orthopedics.

[27]  J. C. Flynn,et al.  Anterior fusion of the lumbar spine. End-result study with long-term follow-up. , 1979, The Journal of bone and joint surgery. American volume.

[28]  S SACKS,et al.  ANTERIOR INTERBODY FUSION OF THE LUMBAR SPINE. , 1965, The Journal of bone and joint surgery. British volume.

[29]  J. Lane,et al.  TRANSPERITONEAL APPROACH TO THE INTERVERTEBRAL DISC IN THE.LUMBAR AREA , 1948, Annals of surgery.

[30]  R. N. Stauffer Anterior Interbody Lumbar Spine Fusion , 2006 .

[31]  J. Lazennec,et al.  Anatomic basis of minimal anterior extraperitoneal approach to the lumbar spine , 2005, Surgical and Radiologic Anatomy.

[32]  M. Aebi,et al.  Synframe: a preliminary report , 2000, European Spine Journal.

[33]  T J Masaryk,et al.  Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. , 1988, Radiology.