Razzouk Jacob, Cheng Daniel, Carter Davis, Mehta Shaurya, Ramos Omar, Cheng Wayne
Orthopaedic Surgery, School of Medicine, Loma Linda University, Loma Linda, USA.
Biological Sciences, University of Southern California, Los Angeles, USA.
Cureus. 2024 Feb 28;16(2):e55139. doi: 10.7759/cureus.55139. eCollection 2024 Feb.
Reports on the outcomes following instrumented anterior lumbar interbody fusion (ALIF) with anterior plate fixation are limited. The aim of this study was to assess the clinical and radiographic outcomes of patients undergoing ALIF with anterior plate fixation. Methods: Medical records and radiographic imaging were reviewed for 100 patients who received ALIF with anterior plate fixation between 2008 to 2021 and completed at least one year of follow-up and postoperative imaging. Prospectively collected patient data included indication for surgery, BMI, age, number and location of levels treated, complications, reoperation rates, fusion rate, and measurements of global lordosis, disc space height, and segmental angulation. Results: A total of 100 patients were included in this study. The mean length of follow-up was 81.37 months. Changes in preoperative-to-postoperative Oswestry Disability Index (ODI) and Visual Analog Score (VAS) demonstrated improvements of 30.86% and 18.56%, respectively. Major vascular injuries occurred in 3% of the cases. A hardware failure rate of 5% was observed. The reoperation rate was 10%. The radiographic fusion rate derived from computed tomography (CT) and plain film was 95.45% and 88.87%, respectively. Postoperative global lordosis demonstrated a 6.08% increase. Postoperative segmental angulation measurements increased by 57.74%. No statistically significant differences in clinical or radiographic outcomes were observed based on the spine level of fusion or the number of fusions performed. Conclusions: ALIF with anterior plate fixation achieved an adequate fusion rate with improvements in ODI and VAS scores meeting minimal clinically important difference thresholds. Postoperative disc space heights demonstrated significant improvements compared to preoperative measurements.
关于前路腰椎椎间融合术（ALIF）联合前路钢板固定术后疗效的报道有限。本研究的目的是评估接受ALIF联合前路钢板固定患者的临床和影像学疗效。方法：回顾了2008年至2021年间接受ALIF联合前路钢板固定且完成至少一年随访及术后影像学检查的100例患者的病历和影像学资料。前瞻性收集的患者数据包括手术指征、体重指数（BMI）、年龄、治疗节段的数量和位置、并发症、再次手术率、融合率以及整体前凸、椎间隙高度和节段性成角的测量值。结果：本研究共纳入100例患者。平均随访时间为81.37个月。术前至术后奥斯威斯功能障碍指数（ODI）和视觉模拟评分（VAS）的变化分别显示改善了30.86%和18.56%。3%的病例发生了 major 血管损伤。观察到硬件故障率为5%。再次手术率为10%。计算机断层扫描（CT）和平片得出的影像学融合率分别为95.45%和88.87%。术后整体前凸增加了6.08%。术后节段性成角测量值增加了57.74%。基于融合的脊柱节段或融合的节段数，在临床或影像学疗效方面未观察到统计学上的显著差异。结论：ALIF联合前路钢板固定实现了足够的融合率，ODI和VAS评分的改善达到了最小临床重要差异阈值。与术前测量值相比，术后椎间隙高度有显著改善。
