Outcomes and Spinopelvic Changes After Anterior Lumbar Interbody Fusion With a Novel Interbody Fusion Device: A Retrospective Study.

IF 1.7 Q2 SURGERY

International Journal of Spine Surgery Pub Date : 2024-09-12 DOI:10.14444/8621

Ankit Hirpara, Christina Koshak, Eric Marty, Christopher Gallus, Christopher Kleck

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引用次数: 0

Abstract

Background: Interbody devices in anterior lumbar interbody fusion (ALIF) are currently a focus of innovation due to their potential to improve clinical outcomes. The purpose of the present study was to analyze complications and changes in spinopelvic parameters after ALIF with the novel Medacta MectaLIF interbody fusion device.

Methods: Patients aged 18 to 80 years who underwent multilevel ALIF using this novel implant were identified. Demographic and surgical data were collected. Patients were divided into short- and long-fusion cohorts. A comparison of outcomes between the short- and long-fusion groups was performed using the Student t test for continuous variables and Fisher's exact test and the χ² test for categorical variables. Analysis of the pre- vs postoperative radiographic data for the entire cohort was performed using the 2-tailed Student t test.

Results: One hundred and eight patients met the inclusion criteria. No significant postoperative change was observed in L1-4 lumbar lordosis (LL). L1-S1 LL increased to a mean of 55.1 ± 12.8 (a mean change of 10.7 ± 14.5), and L4-S1 LL increased to a mean of 38.4 ± 8.7 (a mean increase of 7.5 ± 8.2), with pelvic incidence LL mismatch changing from 8.9 ± 15.1 to 1.1 ± 13.5 (n = 102). Related changes in sacral slope and pelvic tilt were also observed (33.0 ± 11.0 to 37.6 ± 10.9 and 19.6 ± 9.5 to 18.2 ± 9.1 [n = 103], respectively). Five patients (4.6%) experienced implant subsidence, 1 (0.9%) had implant migration, and 6 (5.6%) experienced a nonunion. There was no difference in the rates of complications associated with the novel implant in the short- and long-fusion cohorts.

Conclusion: This novel implant achieves correction of spinopelvic parameters with minimal complications. The ability to modify the implant intraoperatively based on the patient's anatomy can help achieve maximal contact area and therefore help reduce the risk of subsidence.

Clinical relevance: This modular implant can achieve correction of spinopelvic parameters with minimal medical and surgical complications.

Level of evidence: 4:

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使用新型椎体间融合器进行腰椎前路椎体间融合术后的效果和脊柱骨变化：回顾性研究

背景：腰椎前路椎体间融合术（ALIF）中的椎体间融合器因其改善临床疗效的潜力而成为当前创新的焦点。本研究旨在分析使用新型 Medacta MectaLIF 椎间融合器进行 ALIF 后的并发症和脊柱骨参数变化：方法：对使用这种新型植入物进行多层次 ALIF 的 18 至 80 岁患者进行鉴定。收集了人口统计学和手术数据。将患者分为短期融合组和长期融合组。对连续变量采用Student t检验，对分类变量采用Fisher's exact检验和χ2检验，比较短融合组和长融合组的结果。使用双尾学生 t 检验对整个组群的术前与术后放射学数据进行分析：结果：有 118 名患者符合纳入标准。术后L1-4腰椎前凸（LL）无明显变化。L1-S1 LL平均增加到55.1 ± 12.8（平均变化为10.7 ± 14.5），L4-S1 LL平均增加到38.4 ± 8.7（平均增加为7.5 ± 8.2），骨盆发生率LL不匹配从8.9 ± 15.1变为1.1 ± 13.5（n = 102）。骶骨斜度和骨盆倾斜度也出现了相关变化（分别从 33.0 ± 11.0 到 37.6 ± 10.9 和 19.6 ± 9.5 到 18.2 ± 9.1 [n = 103]）。5名患者（4.6%）出现种植体下沉，1名患者（0.9%）出现种植体移位，6名患者（5.6%）出现不愈合。新型植入体的并发症发生率在短融合组和长融合组中没有差异：结论：这种新型植入体能矫正脊柱骨盆参数，并发症极少。根据患者的解剖结构在术中修改植入体的能力有助于实现最大的接触面积，从而有助于降低下沉的风险：临床相关性：这种模块化植入物可在医疗和手术并发症最小的情况下实现脊柱骨盆参数的矫正：4:

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来源期刊

International Journal of Spine Surgery Medicine-Surgery

CiteScore

3.10

自引率

0.00%

发文量

162

期刊介绍： The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.