The Morphological Changes in Adjacent Segments Amongst Patients Receiving Anterior and Oblique Lumbar Interbody Fusion: A Retrospective Study.

Kuan-Kai Tung,Chien-Chou Pan,Hsien-Che Ou,Cheng-Hung Lee,Cheng-Min Shih,Fang-Wei Hsu,Yun-Che Wu,Ning-Chien Chin,Kun-Hui Chen,Wen-Xian Lu

doi:10.3390/jcm10235533

Abstract

Adjacent segment disease (ASD) is troublesome condition that has proved to be highly related to spinal malalignment after spinal surgery. Hence, we aimed to evaluate the morphological changes after anterior lumbar interbody fusion (ALIF) and oblique LIF (OLIF) to establish the differences between the two surgical methods in terms of possible ASD avoidance. Fifty patients, half of whom received ALIF while the other half received OLIF, were analyzed with image studies and functional outcomes during the pre-operative and post-operative periods, and 2 years after surgery. Image measurements obtained included spinal-pelvic parameters, index lordosis (IL), segmental lordosis (SL), anterior disc height (ADH), posterior disc height (PDH) and adjacent segment disc angle (ASDA). The ADH and PDH in the adjacent segment decreased in the two groups while OLIF showed greater decrease without radiological ASD noted at 2-year follow-up. Both groups showed an increase in IL after surgery while ALIF showed greater improvement. No statistical difference was identified in functional outcomes between LIFs. We suggest that both ALIF and OLIF can restore adequate lordosis and prevent ASD after surgery. However, it should be noted that patient selection remains crucial when making any decision involving which of the two methods to use.

Highlights

Introduction conditions of the Creative CommonsSpinal fusion after decompression remains the standard treatment for symptomatic low back pain in adults after the use of conservative strategies fails
50 50 patients in this study, After and gender, gender,we weenrolled enrolled a total patients in this study, including who received and who received with posterior instrumenta‐
We reported the morphological change in adjacent disc, sagittal alignment, and functional outcomes

Summary

Introduction

Introduction conditions of the Creative CommonsSpinal fusion after decompression remains the standard treatment for symptomatic low back pain in adults after the use of conservative strategies fails. The introduction and increased adoption of the lumbar interbody fusion (LIFs) technique, including. The term radiographic ASD is defined as radiographic changes in segments adjacent to the fusion levels occurring with or without clinical symptoms [3]. Symptomatic ASD may be diagnosed with clinical symptoms such as worsening back pain, leg pain, or even intermittent claudication during the post-operative (post-OP) follow-up. These problematic complications necessitate further surgical interventions and worsen the surgical outcomes [4]. Biomechanical changes, such as increasing segmental motion and mechanical stress are considered as precipitators of degenerative stress and ASD

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