Abstract
IntroductionAs a possible treatment option for chronic lower back pain (CLBP) due to single-level degenerative disc disorder (DDD), the efficacy of anterior lumbar interbody fusion (ALIF) has been reviewed various times in the existing literature. Nevertheless, a scarcity of data exists pertaining to ALIF procedures carried out in a short-stay setting using an Enhanced Recovery after Surgery (ERAS) protocol, particularly concerning the safety.MethodsProspectively collected data are analyzed to study the efficacy and safety of short-stay ERAS ALIF in treatment of single-level DDD. Visual Analog Scale (VAS) in both back and leg pain along with the Oswestry Disability Index (ODI) were used to collect measure outcomes. The primary endpoint was a minimum clinically important difference (MCID) of ≥30% for the ODI at 12 months.ResultsForty-four patients underwent surgery after failed long-term conservative treatment. MCID was achieved in 78%. Age was the only significant factor in association with MCID (p = 0.03), while gender, Modic changes, results of prognostic tests, prior surgery and smoking status had no significant influence on either MCID or change scores for any outcome measure. One complication in the form of transient new radiculopathy occurred in one patient (2.3%).ConclusionWith overall positive outcomes in terms of both efficacy and safety, an ALIF procedure with subsequent implementation of an ERAS protocol in a short-stay setting can be an option for strictly selected patients with CLBP. Further study, however, possibly with a larger sample size, would be necessary to substantiate these findings.
Highlights
As a possible treatment option for chronic lower back pain (CLBP) due to single-level degenerative disc disorder (DDD), the efficacy of anterior lumbar interbody fusion (ALIF) has been reviewed various times in the existing literature
Age was the only significant factor in association with minimum clinically important difference (MCID) (p = 0.03), while gender, Modic changes, results of prognostic tests, prior surgery and smoking status had no significant influence on either MCID or change scores for any outcome measure
Postoperative radiculopathy appeared in one patient (2.3%), but the issue resolved after six weeks. Aside from this none of the complications associated with ALIF, such as retrograde ejaculation, incisional hernia, or vascular injuries among others, were observed in this study. In this evaluation of a prospective registry, among 44 patients undergoing ALIF for degenerative disc disease using an Enhanced Recovery after Surgery (ERAS) protocol in a short-stay setting, efficacy, and safety was assessed
Summary
Using data from a prospective registry, we aim to evaluate the safety and efficacy of ALIF for single-level DDD in a short-stay setting, as well as to identify predictors of surgical success
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