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

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.

Comparison of radiographic and clinical outcomes between ALIF, OLIF, and TLIF over 2-year follow-up: a comparative study

“…[ 20 ]. In our previous study, we demonstrated the comparable clinical efficacy between ALIF and OLIF with no clinical symptomatic ASD having been developed, despite the flattened shape change in the supra-adjacent disk during a 2-year follow-up period [ 21 ]. All in all, OLIF possessed advantage in reducing blood loss, restoring lumbar lordosis and the accessibility at L1 to L4 level while simultaneously achieving comparable clinical improvement.…”

Analysis of Risk Factors for Adjacent Segment Degeneration after Minimally Invasive Transforaminal Interbody Fusion at Lumbosacral Spine

“…Chung and colleagues also agreed with the notion that laminectomy and DA are interactive [ 11 ]. A possible rational explanation for our conclusion that unfavorable DA correction is significantly associated with radiological ASD is that the lordosis restored by TLIF approach is usually limited compared to ALIF [ 21 ]. In other words, for patients with unstable lordosis, the implanted cage is the most direct factor that helps to correct the alignment.…”