Combined anterior interbody fusion and posterior pedicle screw fixation in patients with degenerative lumbar disc disease

Abstract

We reviewed 47 consecutive patients with degenerative lumbar disc disease. All patients were treated by anterior interbody fusion using an autogenous iliac bone graft in combination with posterior pedicle fixation but without a posterior fusion. There were 32 men and 15 women with a mean age of 44 (range 23-56) years. One third (n=15) of the patients had previous surgery. We saw complications in six patients including two with vascular injury. The mean follow-up was 2.2 years. Seventy-two per cent of the cases had a satisfactory clinical outcome, and the overall fusion rate was 97%.

Cantilever TLIF With Structural Allograft and RhBMP2 for Correction and Maintenance of Segmental Sagittal Lordosis

“…Although the combined procedure has been effective in obtaining and maintaining correction of lumbar lordosis, 9,10 the potential risks associated with the additional anterior approach have to be considered carefully. 1,2,11 This is especially true in males because of the risk of retrograde ejaculation. The risk of retrograde ejaculation has been reported as high as 13.3% with the transperitoneal and 1.7% with the retroperitoneal approaches.…”

“…Additional complications with the anterior approach include major vascular injury, ureter injury, and lymphatic injury with resultant lymphocele or chronic lower extremity edema. 11,12 The overall complication rate secondary to the approach is 38% in some retrospective studies. 12 Furthermore, the anterior surgical complication rates increase in revision abdominal surgeries.…”

A Radiological Comparison of Anterior Fusion Rates in Anterior Lumbar Interbody Fusion

“…Cages used in anterior lumbar fusions obviate the need for large corticocancellous grafts in which postoperative subsidence and donor site morbidity may be a problem. In 2004 the senior author published the results of 47 patients treated by ALIF with autogenous structural graft and posterior pedicle screw fixation without posterior fusion 7. A 97% fusion rate was achieved at 2-year follow-up based on plain radiographs with 72% satisfactory clinical outcome.…”

Anterior Lumbar Interbody Fusion with Stand-Alone Interbody Cage in Treatment of Lumbar Intervertebral Foraminal Stenosis : Comparative Study of Two Different Types of Cages

“…Anterior lumbar interbody fusion (ALIF) has been considered as one of the major surgical modalities of the degenerative lumbar disc diseases 6,7,16,17) . Particularly in the cases of lumbar intervertebral foraminal stenosis (IFS) causing by various pathologies, many reports have stated that ALIF could be effective to secure the intervetrabla foraminal (IVF) height and decompress the exiting nerve root 8,12,13,27,29) .…”

“…Regrettably, early reports of laparoscopic single anterior surgery with stand-alone cage had noted unacceptable low fusion success rate 24,30) . Therefore, single laparoscopic ALIF has been abandoned, or performed with an additional posterior instrumentation 1,7,10,22) . Recently, the improved devices to enhance a stabilization effect for single anterior surgery have been introduced and promoted the fusion rate.…”