Background: There is limited information on clinical outcomes after anterior lumbar interbody fusion (ALIF) based on the indications for surgery.
Objective: To compare the clinical and radiological outcomes of ALIF for each surgical indication.
Methods: This prospective clinical study included 125 patients who underwent ALIF over a 2-year period. The patients were evaluated pre- and post-operatively. Outcome measures included the SF-12, Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), and Patient Satisfaction Index (PSI).
Results: After a mean follow-up of 20 months, the clinical condition of the patients was significantly better than their preoperative status across all indications. A total of 108 patients had a PSI score of 1 or 2, indicating a successful clinical outcome in 86%. Patients with degenerative disc disease (DDD, with and without radiculopathy), spondylolisthesis and scoliosis had the best clinical response to ALIF, with statistically significant improvement in the SF12, ODI and VAS. Failed posterior fusion and adjacent segment disease (ASD) showed statistically significant improvement in all of these clinical outcome scores, although the mean changes in the SF12 MCS, ODI and VAS (back pain) were lower. The overall radiological fusion rate was 94.4%. Superior radiological outcomes (fusion >90%) were observed in patients with DDD (with and without radiculopathy), spondylolisthesis and failed posterior fusion, while in ASD it was 80%.
Conclusion: ALIF is an effective treatment for DDD (with and without radiculopathy) and spondylolisthesis. While results were promising for scoliosis, failed posterior fusion, and adjacent segment disease (ASD), further studies are necessary to establish ALIF’s effectiveness in these.
From: Outcomes of Anterior Lumbar Interbody Fusion (ALIF) Surgery Based on Indication: A Prospective Study by Rao et al.