Retrospective analysis of medium-term outcomes following anterior lumbar interbody fusion surgery performed in a tertiary spinal surgical centre.

IF 1.1 4区 医学 Q3 SURGERY
T Srirangarajan, K Eseonu, B Fakouri, P Liantis, P Panteliadis, J Lucas, T Ember, M Harris, M Tyrrell, B Sandford, J R Panchmatia
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引用次数: 0

Abstract

Introduction: Anterior lumbar interbody fusion (ALIF) can treat spondylolisthesis, degenerative disc disease and pseudoarthrosis. This approach facilitates complete discectomy, disc space distraction, indirect decompression of neural foramina and placement of large interbody devices. Several intra- and postoperative complications can be attributed to the anterior approach: vascular/visceral injury, hypogastric plexus injury and urogenital consequences. Spine-specific complications include implant migration, graft failure, pseudoarthrosis and persistent symptomology.

Methods: This retrospective study reviewed patient demographics, medium-term outcomes and complication rates following ALIF surgery performed over a 5-year period. A total of 110 consecutive patients had undergone ALIF surgery at a single tertiary spinal centre. The database was reviewed with a primary outcome of identifying postoperative 90-day complications and whether a revision anterior operation was required after primary ALIF.

Results: No patients required revision anterior operation after their primary ALIF surgery by final follow-up. Out of 110 patients, 11 (10%) recorded a complication attributed to the anterior stage of their operation within 90 days.

Conclusions: Our 90-day complication rate of 10% lies within the 2.6% acute complication and 40% overall complications rates described in previous literature. The risk of vascular/visceral injury is significant (3%) and we recommend that ALIF be performed as a dual surgeon procedure with a vascular-trained access surgeon accompanying the spinal surgeon. ALIF is a valid revision surgical option for failed posterior approaches leading to complications such as pseudoarthrosis. In our sample, 89% of patients were managed with posterior fixation to augment the anterior fusion as, biomechanically, this is a proven construct.

对一家三级脊柱外科中心进行的前路腰椎椎间融合手术中期疗效的回顾性分析。
导言:腰椎前路椎体间融合术(ALIF)可治疗脊柱滑脱症、椎间盘退行性病变和假关节。这种方法有利于进行完全椎间盘切除、椎间盘间隙牵开、神经孔间接减压和放置大型椎体间融合器。一些术中和术后并发症可归因于前路:血管/内脏损伤、胃下神经丛损伤和泌尿生殖系统后果。脊柱特有的并发症包括植入物移位、移植物失败、假关节和持续症状:这项回顾性研究回顾了 5 年间 ALIF 手术的患者人口统计学特征、中期疗效和并发症发生率。共有110名患者在一家三级脊柱中心接受了ALIF手术。对数据库进行审查的主要目的是确定术后90天的并发症以及初次ALIF术后是否需要进行翻修前路手术:结果:在最终随访中,没有患者在初次 ALIF 手术后需要进行翻修前路手术。在110名患者中,有11人(10%)在90天内发生了前路手术并发症:我们的 90 天并发症发生率为 10%,与之前文献中描述的 2.6% 的急性并发症发生率和 40% 的总体并发症发生率相当。血管/内脏损伤的风险很高(3%),因此我们建议ALIF手术应由两名外科医生共同完成,一名接受过血管入路培训的外科医生应与脊柱外科医生同行。对于导致假关节等并发症的失败后路手术,ALIF 是一种有效的翻修手术选择。在我们的样本中,89%的患者采用后路固定来增强前路融合,因为从生物力学角度来看,这是一种行之有效的结构。
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来源期刊
CiteScore
2.40
自引率
0.00%
发文量
316
期刊介绍: The Annals of The Royal College of Surgeons of England is the official scholarly research journal of the Royal College of Surgeons and is published eight times a year in January, February, March, April, May, July, September and November. The main aim of the journal is to publish high-quality, peer-reviewed papers that relate to all branches of surgery. The Annals also includes letters and comments, a regular technical section, controversial topics, CORESS feedback and book reviews. The editorial board is composed of experts from all the surgical specialties.
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