Safety and efficacy of stand-alone anterior lumbar interbody fusion in low-grade L5-S1 isthmic spondylolisthesis

Jesse, Christopher Marvin; Schwarzenbach, Othmar; Häni, Levin; Raabe, Andreas; Schär, Ralph T.

doi:10.1016/j.bas.2022.100861

Cited by 5 publications

(2 citation statements)

References 27 publications

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“…Radiographic con rmation of low back pain originating from the L4-5 IS was determined by the treating surgeon and a neuroradiologist. Seven patients had grade I vertebral slippage, and the others had grade II vertebral slippage according to the Meyerding classi cation method [21].…”

Section: Subjectsmentioning

confidence: 99%

Segmental Vertebral Three-dimensional Motion in Patients with L4 Isthmic Spondylolisthesis under Weight-bearing Conditions

Xu,

Deng,

et al. 2024

Preprint

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Objective To investigate in vivo 6-degree-of-freedom (DOF) vertebral motion in patients with isthmic spondylolisthesis (IS) during various functional weight-bearing activities. Methods Fifteen asymptomatic volunteers (mean age 54.8 years) and fourteen patients with IS at L4-5 (mean age 53.4 years) were recruited. The positions of the vertebrae (L4-L5) in the supine, standing, flexion-extension, left-right twisting and left-right bending positions were determined using previously described CT-based models and dual fluoroscopic imaging techniques. Local coordinate systems were established at the center of the anterior vertebra of L4 isthmic spondylolisthesis (AIS), the posterior lamina of L4 isthmic spondylolisthesis (PIS) and the center of the L5 vertebra to obtain the 6DOF range of motion (ROM) at L4-L5 and the range of motion (ROM) between the AIS and the PIS. Results The translation along the anteroposterior axis at L4-L5 during flexion-extension, left-right bending and left-right twisting was significantly greater than that of the healthy participants. However, the translation along the mediolateral axis at L4-L5 presented paradoxical motion under different positions: the ROM increased in the supine-standing and flexion-extension positions but decreased in the left-right bending and left-right twisting positions. The separation along the anteroposterior axis during flexion was significantly greater than that during standing, on average, reaching more than 1 mm. The separation along the mediolateral axis during standing, flexion and extension was significantly greater than that in the supine position. Conclusions This study revealed the occurrence of displacement between the AIS and PIS, primarily in the form of separation during flexion. Symptomatic patients with isthmic spondylolisthesis exhibit intervertebral instability, which might be underestimated by flexion-extension radiographs.

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Section: Subjectsmentioning

confidence: 99%

Segmental Vertebral Three-dimensional Motion in Patients with L4 Isthmic Spondylolisthesis under Weight-bearing Conditions

Xu,

Deng,

et al. 2024

Preprint

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“…The surgical technique has been described in more detail previously. 16 Patients with osteopenic or osteoporotic bone conditions underwent an additional vertebroplasty with bone cement, which was applied through a small cannulated needle by puncturing the vertebral bodies at L5 and S1 in the median line in the proximity of the lower, and higher endplates.…”

Section: Surgical Techniquementioning

confidence: 99%

Anterior Lumbar Interbody Fusion in Elderly Patients: Peri- and Postoperative Complications and Clinical Outcome

Jesse

Mayer

Häni

et al. 2023

J Neurol Surg A Cent Eur Neurosurg

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Background Anterior lumbar interbody fusion (ALIF) is an effective surgical technique for treating various lumbar pathologies, but its use in elderly patients is controversial. Data concerning complications and effectiveness are sparse. We investigated peri- and postoperative complications, radiographic parameters, and clinical outcome in elderly patients. Methods Patients ≥65 years who underwent ALIF between January 2008 and August 2020 were included in the study. All surgeries were performed through a retroperitoneal approach. Clinical and surgical data as well as radiologic parameters were collected prospectively and analyzed retrospectively. Results A total of 39 patients were included; the mean age was 72.6 (±6.3) years (range: 65–90 years); and the mean American Society of Anesthesiologists (ASA) risk classification was 2.3 (±0.6). A laceration of the left common iliac vein was the only major complication recorded (2.6%). Minor complications occurred in 20.5% of patients. Fusion rate was 90.9%. Reoperation rate at the index level was 12.8 and 7.7% in adjacent segments. The multidimensional Core Outcome Measures Index (COMI) improved from 7.4 (±1.4) to 3.9 (±2.7) after 1 year and to 3.3 (±2.6) after 2 years. Oswestry disability index (ODI) improved from 41.2 (±13.7) to 20.9 (±14.9) after 1 year and to 21.5 (±18.8) after 2 years. Improvements of at least the minimal clinically important change score of 2.2 and 12.9 points in the ODI and COMI after 2 years were noted in 75 and 56.3% of the patients, respectively. Conclusion With careful patient selection, ALIF is safe and effective in elderly patients.

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Minimally Invasive Transforaminal versus Anterior Lumbar Interbody Fusion in Patients Undergoing Revision Fusion: Clinical Outcome Comparison

Nie

Hartman²,

Jacob³

et al. 2022

World Neurosurgery

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Safety and efficacy of stand-alone anterior lumbar interbody fusion in low-grade L5-S1 isthmic spondylolisthesis

Cited by 5 publications

References 27 publications

Segmental Vertebral Three-dimensional Motion in Patients with L4 Isthmic Spondylolisthesis under Weight-bearing Conditions

Segmental Vertebral Three-dimensional Motion in Patients with L4 Isthmic Spondylolisthesis under Weight-bearing Conditions

Anterior Lumbar Interbody Fusion in Elderly Patients: Peri- and Postoperative Complications and Clinical Outcome

Minimally Invasive Transforaminal versus Anterior Lumbar Interbody Fusion in Patients Undergoing Revision Fusion: Clinical Outcome Comparison

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