Clinical outcome of stand-alone ALIF compared to posterior instrumentation for degenerative disc disease: A pilot study and a literature review

Anterior Lumbar Interbody Fusion Integrated Screw Cages: Intrinsic Load Generation, Subsidence, and Torsional Stability

“…A spurt of clinical trials ensued the favorable biomechanical findings, demonstrating that stand‐alone cages can provide comparable fusion and clinical outcomes to supplementary fixation. Stand‐alone cages additionally reduced operative time and iatrogenic trauma, albeit one study recommended consideration of additional posterior fusion in cases of obesity and degenerative spondylolisthesis, to optimize fusion and reduce subsidence.…”

“…Their development has stimulated a variety of biomechanical studies comparing their stability to conventional supplementary fixation substantiating a provision of “sufficient” stability, thus the progression to the next phase of clinical trials. Clinical trials evaluating the efficacy of stand‐alone cages with integrated fixation and supplementary fixation methods have demonstrated comparable postoperative outcomes, yet significant reduction in surgical time and earlier postoperative improvement. Subsidence of the vertebral endplate due to implant penetration is a frequent clinical occurrence due to the transition in the intervertebral space from a large surface area, high compliance disc to a rigid implant with comparatively small surface area, significantly altering the distribution of stress.…”

Alif With Auto-Locking Cage Without Supplementation - Tomographic Analysis of Interbody Bone Fusion

“…The surgical options for interbody fusion of the lumbar spine include: posterior lumbar interbody fusion (PLIF Anterior) access is indicated for the more distal levels of the spine and offers several advantages as compared with other approaches, among them the possibility of a wide discectomy, a greater gain in lordosis at the level of interest, a low risk of injury to the posterior neural structures, and less risk of lesion of the posterior musculature that supports the spine. [3][4] However, there are several disadvantages to this approach. The most commonly cited in the literature include the danger of bleeding due to the proximity to large blood vessels and the possibility of retrograde ejaculation from the chance of damage to the hypogastric nerve that passes in front of the spine.…”

“…The most commonly cited in the literature include the danger of bleeding due to the proximity to large blood vessels and the possibility of retrograde ejaculation from the chance of damage to the hypogastric nerve that passes in front of the spine. [2][3][4][5] In an attempt to reduce morbidity and interoperative complications from the surgical approach, less invasive techniques like as the anterior retroperitoneal approach for lumbar fusion (mini-ALIF) have evolved. This option consists of a smaller incision, blunt dissection of the abdominal muscles, and retroperitoneal access to reach the spine, which, together, require less surgical time and result in less interoperative bleeding.…”

Radiographic and Surgical Outcomes After Stand-Alone Lateral Lumbar Interbody Fusion

“…This technique forgoes posterior fixation with a pedicle screw-rod construct in the appropriately selected patient with a stable spinal segment. The obvious benefits include decreased blood loss, shorter operative time, and absence of posterior soft-tissue disruption (11)(12)(13). Scant data exists regarding surgical and radiographic outcomes following this treatment algorithm that intuitively may have the benefits of decreasing adjacentsegment forces and the potential disadvantage of a lessstable fusion construct.…”