Anterior lumbar interbody fusion versus transforaminal lumbar interbody fusion – systematic review and meta-analysis

Phan, Kevin; Thayaparan, Ganesha K.; Mobbs, Ralph J.

doi:10.3109/02688697.2015.1036838

Cited by 187 publications

(144 citation statements)

References 24 publications

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“…Adequate mobilization of the vessels to allow a direct visualisation and approach is a crucial process in this procedure (3). It is also important for regular relaxation of the retractors to ensure adequate blood flow to the lower limb.…”

Section: Discussionmentioning

confidence: 99%

Anterior lumbar vertebrectomy via direct anterior approach: technical note

et al. 2017

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Clinical vignetteThe authors report the case of a 67-year-old female who presented with progressive worsening of low back pain for a period of 3 to 4 weeks, with acute severe deterioration over one week associated with left quadriceps weakness and absence of knee reflex. Imaging reveals a lytic lesion on the L4 vertebral body, with a pathological fracture. Positron emission tomography (PET) revealed significant uptake in the L4 vertebral body and minimal uptake in the lungs. Surgical removal of the lesion was recommended as the choice of treatment. An anterior approach for a complete vertebrectomy and a conventional minimally invasive posterior approach for lumbar interbody fusion 3 days postanterior vertebrectomy was planned. The anterior approach for complete L4 vertebrectomy was documented in the presented video.Technical note (Figure 1) The patient was placed in a supine position and a midline incision from the symphysis to the umbilicus was performed. Retroperitoneal dissection with blunt dissection was performed via a left sided approach, with fixed-bedbased round retractor and multiple retraction blades to reveal the retroperitoneum. Mobilization of the aorta and inferior vena cava was performed with ligation of segmental vessels. A key point here is ligation of the iliolumbar vein, which allows safe mobilization and retraction of the left common iliac vein and the inferior vena cava, which was performed using ligaclip and suture tie. These steps allow exposure of the appropriate surgical anatomy (Figure 2).The L4 vertebrae, L3/4 and L4/5 intervertebral discs were then removed. Complete vertebrectomy was performed using piecemeal technique using drill and bone nibblers of the L4 vertebral body along with the tumour.

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Section: Discussionmentioning

confidence: 99%

Anterior lumbar vertebrectomy via direct anterior approach: technical note

et al. 2017

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“…The benefits of the TLIF over the PLIF is the ability to perform the interbody fusion with less retraction and manipulation of the neural elements and ability to place larger cage. The TLIF approach maintains important midline ligaments [73,[76][77][78].…”

Section: Tlifmentioning

confidence: 99%

Role of Minimally Invasive Spine Surgery in Adults with Degenerative Lumbar Scoliosis: A Narrative Review

Tannoury

Haddadi

Kempegowda

et al. 2017

IrJNS

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Background and Aim: Degenerative lumbar scoliosis is a spinal deformity resulting from advanced disc degeneration and facet arthropathy. Given the inconclusive available literature and lack of high-quality data supporting the role of minimally invasive surgical management of degenerative lumbar scoliosis, this review intends to highlight and compare the various viable minimally invasive surgical methods for adult degenerative deformity correction. Methods and Materials/Patients:Online databases search including Medline, PubMed and Ovid was preformed using the keywords: adult, degenerative, lumbar scoliosis, etiology, clinical issues, diagnostic imaging, spinopelvic alignment, non-operative and surgical treatment options, minimally invasive, interbody fusion, and percutaneous pedicle screw fixation. Eighty-three studies, published after 2000, on degenerative lumbar scoliosis epidemiology, classification and management were identified and reviewed.Results: Minimally invasive surgical techniques available for interbody fusion include posterior lumbar interbody fusion, transformational lumbar interbody fusion, oblique lumbar interbody fusion, anterior lumbar interbody fusion, and extreme lateral interbody fusion. Each surgical option warrants technical considerations, indication, complications awareness, and functional and radiological outcomes assessment. Sound patients' selection is key for improved outcomes, and therefore the following factors should be well examined prior to surgical intervention: the patient's medical condition and underlying morbidities, the extent of the involved disc spaces, imaging characteristics, and surgeon skills. Conclusion:The superiority of one surgical technique over the others, was not proven due to lack of strong and supportive data. However, a comprehensive review of indications, benefits, and disadvantages of the minimally invasive surgical procedures is presented. There is an interest in minimally invasive surgery of the spine owing to lower complication rates and morbidity, with limited soft tissue disturbance, decreased blood loss, improved cosmesis, shorter hospital stay, earlier return to work, and therefore decreased general health care costs.

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“…Current available data suggest that ALIF can offer significant functional improvement and pain management 4 and that the procedure is associated with a high fusion rate 5 , with patient-reported functional and disability outcomes at least comparable to open procedures 6 . The complications associated with ALIF are distinct from posterior fusion procedures such as posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) [7][8][9] . Anterior fusion is associated with a higher risk of potentially life-threatening perioperative vascular complications following injury to any of the great vessels or their branches.…”

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confidence: 99%

Anterior Lumbar Interbody Fusion in Left‐sided Inferior Vena Cava and Right‐sided Aortic Arch

Phan

Fang²,

Maharaj

et al. 2017

Orthopaedic Surgery

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Spinal fusion via anterior lumbar interbody fusion (ALIF) can offer symptomatic relief to patients that suffer severe low back pain, radiculopathy, and claudication. However, a detailed working knowledge of the thoracic, abdominal, and lumbar anatomy, particularly of the vasculature, is vital. We report the case of a 68-year-old man who presented with radiculopathy and progressively worsening low back pain despite 9 months of unsuccessful conservative therapy and pain management. Preoperative computed tomography and magnetic resonance imaging revealed a rare anatomical variation, with an anomalous left-sided inferior vena cava and anomalous aorta. The patient was surgically treated with ALIF at L 4,5 and L 5 S 1 via an altered surgical window. Given the anomalous anatomy of the patient, instead of performing the procedure after mobilizing both of the transposed abdominal great vessels, the inferior vena cava and the abdominal aorta, the ALIF was uneventfully performed in the window between these vessels. There were no perioperative or postoperative complications. At 12-week postoperative follow-up, X-ray imaging demonstrated successful implantation of ALIF cages with no recurrence of symptoms. A detailed working knowledge of anatomy is important, particularly if anatomical variations are present. This has implications for preoperative surgical planning, which is integral to the safety and the success of procedures.

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Anterior lumbar interbody fusion versus transforaminal lumbar interbody fusion – systematic review and meta-analysis

Abstract: ALIF and TLIF appear to have similar success and clinical outcomes, with different complication profiles. ALIF may be associated with superior restoration of disk height and lordosis, but requires further validation in future studies.

Cited by 187 publications

References 24 publications

Anterior lumbar vertebrectomy via direct anterior approach: technical note

Anterior lumbar vertebrectomy via direct anterior approach: technical note

Role of Minimally Invasive Spine Surgery in Adults with Degenerative Lumbar Scoliosis: A Narrative Review

Anterior Lumbar Interbody Fusion in Left‐sided Inferior Vena Cava and Right‐sided Aortic Arch

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