Clinical and radiological outcomes after stand-alone ALIF for single L5-S1 degenerative discopathy using a PEEK cage filled with hydroxyapatite nanoparticles without bone graft

Norotte, Gilles; Barrios, Carlos

doi:10.1016/j.clineuro.2018.01.037

Cited by 16 publications

(7 citation statements)

References 27 publications

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“…Previous published studies on posterior fusion have reported fusion rates of 0–100% for bioactive glass (with or without autologous bone) [ 2 – 4 , 11 , 13 , 15 , 16 , 22 , 27 ], with only one of nine studies not recommending the use of bioactive glass [ 2 ] (Table 4 ). Furthermore, our fusion rate of 97% and complication rate of 5% are consistent with those reported for other studies investigating ALIF [ 5 , 20 , 26 ]. Of the 40 patients included in the present study, there were 2 patients that had to be reoperated because of inadequate fusion at L4-L5.…”

Section: Discussionsupporting

confidence: 92%

Bioactive glass grants equivalent fusion compared to autologous iliac crest bone for ALIF: a within-patient comparative study

et al. 2022

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Purpose To determine within-patient fusion rates of chambers filled with bioactive glass versus autologous iliac crest bone on computed tomography (CT) following anterior lumbar interbody fusion (ALIF). Methods A consecutive series of 40 patients (58 levels) that underwent single-level (L5-S1 only) or two-level (L5-S1 and L4-L5) ALIF were assessed. Indications for fusion were one or more of the following: degenerative disc disease with or without Modic changes, spondylolisthesis, and stenosis. Each intervertebral cage had a middle beam delimiting two chambers, one of which was filled with bioactive glass and the other with autologous iliac crest bone. CT scans were graded using the Bridwell classification (grade I, best; grade IV, worst). Patients were evaluated using the Oswestry Disability Index (ODI), and by rating pain in the lower back and legs on a Visual Analog Scale (pVAS); complications and reoperations were noted. Results At 15 ± 5 months follow-up, there were no significant differences in fusion across chambers filled with bioactive glass versus chambers filled with autologous bone (p = 0.416). Two patients with Bridwell grade III at both chambers of the L4-L5 cages required reoperation using posterior instrumentation. Clinical assessment of the 38 remaining patients (54 levels) at 25 ± 2 months, revealed ODI of 15 ± 12, lower back pVAS of 1.4 ± 1.5 and legs pVAS of 1.9 ± 1.6. Conclusions For ALIF at L5-S1 or L4-L5, within-patient fusion rates were equivalent for bioactive glass compared to autologous iliac crest bone; thus, bioactive glass can substitute autologous bone, avoiding increased operative time and blood loss, as well as donor site morbidity.

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Section: Discussionsupporting

confidence: 92%

Bioactive glass grants equivalent fusion compared to autologous iliac crest bone for ALIF: a within-patient comparative study

et al. 2022

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“…Supplemental screw fixation can be performed to prevent anterior cage migration following OLIF at the L5–S1 level. Supplemental screw fixation at the anterior aspect of L5–S1 was initially introduced in stand-alone ALIF with favorable radiological outcomes [ 31 , 32 ]. Chung et al [ 33 ] retrospectively reviewed 61 patients who underwent OLIF and pedicle screw fixation at the L5–S1 level and found that anterior cage migration was significantly reduced in cases where supplemental screw fixation was performed.…”

Section: Surgical Techniques and Considerationsmentioning

confidence: 99%

Pearls and Pitfalls of Oblique Lateral Interbody Fusion: A Comprehensive Narrative Review

Kim

Chang

2022

Neurospine

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Lumbar degenerative disease is a common problem in an aging society. Oblique lateral interbody fusion (OLIF) is a minimally invasive surgical (MIS) technique that utilizes a retroperitoneal antepsoas corridor to treat lumbar degenerative disease. OLIF has theoretical advantages over other lumbar fusion techniques, such as a lower risk of lumbar plexus injury than direct lateral interbody fusion (DLIF). Previous studies have reported favorable clinical and radiological outcomes of OLIF in various lumbar degenerative diseases. The use of OLIF is increasing, and evidence on OLIF is growing in the literature. The indications for OLIF are also expanding with the help of recent technical developments, including stereotactic navigation systems and robotics. In this review, we present current evidence on OLIF for the treatment of lumbar degenerative disease, focusing on the expansion of surgical indications and recent advancements in the OLIF procedure.

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“…Another limitation of this study is the lack of patient-reported outcomes. The outcomes of lumbar disc replacement, [33][34][35] including multilevel 31,36 or stand-alone ALIF, 37,38 have been reported by many other authors and was not the aim of the current study, which focuses on evaluating the safety of these procedures performed in an ASC compared with in a hospital setting.…”

Section: Discussionmentioning

confidence: 99%

Outpatient Versus Inpatient Anterior Lumbar Spine Surgery: A Multisite, Comparative Analysis of Patient Safety Measures

et al. 2021

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Background: The frequency and complexity of spinal surgery performed in an ambulatory surgery center (ASC) is increasing. However, safety and efficacy data of most spinal procedures adapted to the ASC are sparse and have focused on anterior cervical surgery. The purpose of this study was to compare the 90-day complication and readmission rates of anterior lumbar spine surgery performed in an ASC or inpatient setting.Methods: We performed a retrospective comparative analysis of 226 consecutive anterior lumbar surgeries (283 levels treated) completed in an ASC (n ¼ 124) or in an inpatient tertiary care hospital (n ¼ 102) over a 3-year period. These included anterior lumbar interbody fusion (ALIF), artificial disc replacement (ADR), and hybrids. Patients undergoing simultaneous or staged posterior procedures within 3 months were excluded. Patient demographics and surgical parameters between the two surgical settings were compared. Ninety-day medical complications and readmission rates were assessed. One-way analysis of variance and Chi-square analysis were used. A P value of less than .05 was considered statistically significant.Results: The two study groups had similar baseline characteristics. While there was a trend toward fewer complications, reoperations, and readmissions for the ASC cohort, the differences were not statistically significant. There were 7 intraoperative complications (5.6% minor vascular injury) in the inpatient cohort and 0 in the ASC cohort. The overall 90-day postoperative complication rate was 5.6% for the inpatient cohort and 0.9% for the ASC cohort. The 90-day readmission rate was 1.9% in the ASC cohort and 1.6% in the inpatient cohort. The 90-day reoperation rate was 0.8% for the inpatient cohort and 0% in the ASC cohort. The average hospital stay was 2.3 6 1.5 days for the inpatient cohort. Conclusion:The 90-day readmission rates were lower for outpatients than for inpatients, while the complication and reoperation rates were similar. Our results demonstrate that anterior lumbar procedures, including single-level and multilevel ALIF, ADR, and hybrid procedures, can be performed safely in an ASC. This has significant cost savings implications for the ASC setting.

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Clinical and radiological outcomes after stand-alone ALIF for single L5-S1 degenerative discopathy using a PEEK cage filled with hydroxyapatite nanoparticles without bone graft

Cited by 16 publications

References 27 publications

Bioactive glass grants equivalent fusion compared to autologous iliac crest bone for ALIF: a within-patient comparative study

Bioactive glass grants equivalent fusion compared to autologous iliac crest bone for ALIF: a within-patient comparative study

Pearls and Pitfalls of Oblique Lateral Interbody Fusion: A Comprehensive Narrative Review

Outpatient Versus Inpatient Anterior Lumbar Spine Surgery: A Multisite, Comparative Analysis of Patient Safety Measures

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