Safety and Efficacy of Anterior Lumbar Interbody Fusion for Discogenic Chronic Low Back Pain in a Short-stay Setting: Data From a Prospective Registry

Vieli, Moira; Staartjes, Victor E.; Eversdjik, Hubert A.J.; Wispelaere, Marlies P. de; Oosterhuis, J. Wolter; Schröder, Marc

doi:10.7759/cureus.5332

Cited by 13 publications

(18 citation statements)

References 31 publications

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“…However, the underlying mechanism for this deficit was not explained or explored. 37 A case series of 2 patients by Saini et al demonstrated S1 radiculopathy after L5-S1 ALIF with stand-alone constructs. The culprit in both cases was identified as nerve root impingement due to a protruding screw tip.…”

Section: Discussionmentioning

confidence: 99%

Vulnerability of the L5 nerve root during anterior lumbar interbody fusion at L5–S1: case series and review of the literature

Dowlati

Alexander

Voyadzis

2020

Neurosurgical Focus

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OBJECTIVENerve root injuries associated with anterior lumbar interbody fusion (ALIF) are uncommonly reported in the literature. This case series and review aims to describe the etiology of L5 nerve root injury following ALIF at L5–S1.METHODSThe authors performed a single-center retrospective review of prospectively collected data of patients who underwent surgery between 2017 and 2019 who had postoperative L5 nerve root injuries after stand-alone L5–S1 ALIF. They also reviewed the literature with regard to nerve root injuries after ALIF procedures.RESULTSThe authors report on 3 patients with postoperative L5 radiculopathy. All 3 patients had pain that improved. Two of the 3 patients had a neurological deficit, one of which improved.CONCLUSIONSStretch neuropraxia from overdistraction is an important cause of postoperative L5 radiculopathy after L5–S1 ALIF. Judicious use of implants and careful preoperative planning to determine optimal implant sizes are paramount.

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Section: Discussionmentioning

confidence: 99%

Vulnerability of the L5 nerve root during anterior lumbar interbody fusion at L5–S1: case series and review of the literature

Dowlati

Alexander

Voyadzis

2020

Neurosurgical Focus

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“…All surgical procedures were performed by a single senior neurosurgeon (M.L.S.) as described previously [43,47,48,51,53]. Due to local restrictive regulations by insurance companies, patients aged > 80 or with a body mass index (BMI) > 33 or American Society of Anaesthesiologists (ASA) score > 2 cannot be considered for elective short-stay spine surgery [49].…”

Section: Designmentioning

confidence: 99%

Influence of dynamic preoperative body mass index changes on patient-reported outcomes after surgery for degenerative lumbar spine disease

2020

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Psychological factors demonstrably and often massively influence outcomes of degenerative spine surgery, and one could hypothesize that preoperative weight loss may correlate with motivation and lifestyle adjustment, thus leading to potentially enhanced outcomes. We aimed to evaluate the effect of preoperative weight loss or gain, respectively, on patient-reported outcomes after lumbar spine surgery. Weight loss was defined as a BMI decrease of ≤ − 0.5 kg/m2 over a period of at least 1 month, and weight gain as a BMI increase of ≥ 0.5 kg/m2 in the same time period, respectively. The primary endpoint was set as the achievement of the minimum clinically important difference (MCID) in the ODI at 1 or 2 years postoperatively. A total of 154 patients were included. Weight loss (odds ratio (OR): 1.18, 95% confidence interval (CI): 0.52 to 2.80) and weight gain (OR: 1.03, 95% CI: 0.43 to 2.55) showed no significant influence on MCID achievement for ODI compared to a stable BMI. The same results were observed when analysing long-term NRS-BP and NRS-LP. Regression analysis showed no correlation between BMI change and PROM change scores for any of the three PROMs. Adjustment for age and gender did not alter results. Our findings suggest that both preoperative weight loss and weight gain may have no measurable effect on long-term postoperative outcome compared to a stable BMI. Weight loss preoperatively—as a potential surrogate sign of patient motivation and lifestyle change—may thus not influence postoperative outcomes.

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“…Within the surgical options for the treatment of LDDD, anterior lumbar interbody fusion (ALIF) plays a crucial role given its ability to improve segmental and global lordosis of the intervened region, also generating adequate foraminal and spinal canal decompression with a low complication profile [6] , [7] , [8] , [9] . The most frequently ALIF intervened level is L5-S1 [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Venous anatomy of the lumbar region applied to anterior lumbar interbody fusion (ALIF): Proposal of a new classification

Moreno

Diaz-Orduz

Berbeo-Calderón

2021

North American Spine Society Journal (NASSJ)

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Background: Anterior lumbar interbody fusion (ALIF) is a good alternative for the surgical treatment of lumbar degenerative disc disease. The primary vascular complications regarding this intervention involve the common iliac vein bifurcation complex (CIVC). Currently, no classification system allows defining which patients are more prone to these complications. We aimed to perform a retrospective study evaluating the anatomy of the common iliac CIVC at the L5-S1 disc proposing a novel classification system as it relates to the ALIF difficulty. Methods: 91 consecutive patients who underwent ALIF at the L5-S1 level were included. We categorize the CIVC at the L5-S1 disc space into four types according to the veins position along the disc space. The patient records were reviewed for demographic information, surgical characteristics, and complications. The surgical difficulty was rated at the end of the procedure. Results: 54% of the patients were women. The mean age was 52.5 ± 14.8 years. Mean surgical bleeding was 152 ml (range 20ml -3000 ml), and mean surgical time was 79 ± 13.3 minutes. Berbeo-Diaz-Vargas (BDV) classification type 4 was found in 43.9% of the patients. The surgical complexity was associated with the bleeding magnitude and surgical time spent (p < 0.01), not being related to the corporal mass index or sacral slope. Bleeding magnitude, surgical time, and surgical complexity were significantly related to the BDV classification system (p < 0.01). Weighted Cohen´s kappa index for the BDV scale was 0.89 (95% IC 0.822 -0.974). Conclusions: BDV scale is a reliable and reproducible tool for the classification of CIVC significantly related to a higher incidence of bleeding, prolonged operating time, and increased perceived difficulty by the surgeon.

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Safety and Efficacy of Anterior Lumbar Interbody Fusion for Discogenic Chronic Low Back Pain in a Short-stay Setting: Data From a Prospective Registry

Cited by 13 publications

References 31 publications

Vulnerability of the L5 nerve root during anterior lumbar interbody fusion at L5–S1: case series and review of the literature

Vulnerability of the L5 nerve root during anterior lumbar interbody fusion at L5–S1: case series and review of the literature

Influence of dynamic preoperative body mass index changes on patient-reported outcomes after surgery for degenerative lumbar spine disease

Venous anatomy of the lumbar region applied to anterior lumbar interbody fusion (ALIF): Proposal of a new classification

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