Jialun Chi, Kate S Woods, Ved A Vengsarkar, Zhiwen Xu, Hanzhi Yang, Abhishek Kumar, Yi Zhang, Zhichang Zhang, Jesse Wang, Lawal Labaran, Li Jin, Xudong Li
{"title":"ALIF和TLIF治疗L5-S1峡部滑脱患者的中短期预后","authors":"Jialun Chi, Kate S Woods, Ved A Vengsarkar, Zhiwen Xu, Hanzhi Yang, Abhishek Kumar, Yi Zhang, Zhichang Zhang, Jesse Wang, Lawal Labaran, Li Jin, Xudong Li","doi":"10.14444/8696","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A limited number of studies have compared the outcomes of anterior lumbar interbody fusion (ALIF) to transforaminal lumbar interbody fusion (TLIF) for the treatment of isthmic spondylolisthesis. This study aims to compare postoperative complications between these two surgical approaches.</p><p><strong>Methods: </strong>A retrospective review was performed using a large national database. The study population included all patients older than 18 years who underwent single-level ALIF or TLIF with a diagnosis of L5 to S1 isthmic spondylolisthesis. A 1:2 propensity score was used to match ALIF and TLIF cohorts for age, sex, and relevant comorbidities, including smoking status. Multivariate logistic regression was used to compare 3-month and 2-year medical and surgical complications, including 5-year reoperation rates.</p><p><strong>Results: </strong>Five hundred and seventy-eight ALIF patients were paired with 1,156 TLIF patients following the match. The analysis revealed a higher 3-month ileus rate in ALIF patients (<i>P</i> = 0.009) and a lower, though not significant difference in, reoperation rate for ALIF within 2 years at 7.1% compared with TLIF at 7.7% (<i>P</i> = 0.696). Five-year reoperation rates were comparable (9.5% vs 10.8%; <i>P</i> = 0.612).</p><p><strong>Conclusions: </strong>Aside from the increased rate of ileus in the ALIF group, there was no significant difference in both short- and mid-term complications, including overall reoperation rate, between the 2 techniques. Spine surgeons should select the optimal technique for a given patient.</p><p><strong>Clinical relevance: </strong>ALIF and TLIF offer comparable mid-term postoperative outcomes for treating 1-level L5/S1 isthmic spondylolisthesis.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Short- and Mid-Term Outcomes Following ALIF and TLIF in L5-S1 Isthmic Spondylolisthesis Patients.\",\"authors\":\"Jialun Chi, Kate S Woods, Ved A Vengsarkar, Zhiwen Xu, Hanzhi Yang, Abhishek Kumar, Yi Zhang, Zhichang Zhang, Jesse Wang, Lawal Labaran, Li Jin, Xudong Li\",\"doi\":\"10.14444/8696\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>A limited number of studies have compared the outcomes of anterior lumbar interbody fusion (ALIF) to transforaminal lumbar interbody fusion (TLIF) for the treatment of isthmic spondylolisthesis. This study aims to compare postoperative complications between these two surgical approaches.</p><p><strong>Methods: </strong>A retrospective review was performed using a large national database. The study population included all patients older than 18 years who underwent single-level ALIF or TLIF with a diagnosis of L5 to S1 isthmic spondylolisthesis. A 1:2 propensity score was used to match ALIF and TLIF cohorts for age, sex, and relevant comorbidities, including smoking status. Multivariate logistic regression was used to compare 3-month and 2-year medical and surgical complications, including 5-year reoperation rates.</p><p><strong>Results: </strong>Five hundred and seventy-eight ALIF patients were paired with 1,156 TLIF patients following the match. The analysis revealed a higher 3-month ileus rate in ALIF patients (<i>P</i> = 0.009) and a lower, though not significant difference in, reoperation rate for ALIF within 2 years at 7.1% compared with TLIF at 7.7% (<i>P</i> = 0.696). Five-year reoperation rates were comparable (9.5% vs 10.8%; <i>P</i> = 0.612).</p><p><strong>Conclusions: </strong>Aside from the increased rate of ileus in the ALIF group, there was no significant difference in both short- and mid-term complications, including overall reoperation rate, between the 2 techniques. Spine surgeons should select the optimal technique for a given patient.</p><p><strong>Clinical relevance: </strong>ALIF and TLIF offer comparable mid-term postoperative outcomes for treating 1-level L5/S1 isthmic spondylolisthesis.</p><p><strong>Level of evidence: 3: </strong></p>\",\"PeriodicalId\":38486,\"journal\":{\"name\":\"International Journal of Spine Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-01-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Spine Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14444/8696\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Spine Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14444/8696","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Short- and Mid-Term Outcomes Following ALIF and TLIF in L5-S1 Isthmic Spondylolisthesis Patients.
Background: A limited number of studies have compared the outcomes of anterior lumbar interbody fusion (ALIF) to transforaminal lumbar interbody fusion (TLIF) for the treatment of isthmic spondylolisthesis. This study aims to compare postoperative complications between these two surgical approaches.
Methods: A retrospective review was performed using a large national database. The study population included all patients older than 18 years who underwent single-level ALIF or TLIF with a diagnosis of L5 to S1 isthmic spondylolisthesis. A 1:2 propensity score was used to match ALIF and TLIF cohorts for age, sex, and relevant comorbidities, including smoking status. Multivariate logistic regression was used to compare 3-month and 2-year medical and surgical complications, including 5-year reoperation rates.
Results: Five hundred and seventy-eight ALIF patients were paired with 1,156 TLIF patients following the match. The analysis revealed a higher 3-month ileus rate in ALIF patients (P = 0.009) and a lower, though not significant difference in, reoperation rate for ALIF within 2 years at 7.1% compared with TLIF at 7.7% (P = 0.696). Five-year reoperation rates were comparable (9.5% vs 10.8%; P = 0.612).
Conclusions: Aside from the increased rate of ileus in the ALIF group, there was no significant difference in both short- and mid-term complications, including overall reoperation rate, between the 2 techniques. Spine surgeons should select the optimal technique for a given patient.
Clinical relevance: ALIF and TLIF offer comparable mid-term postoperative outcomes for treating 1-level L5/S1 isthmic spondylolisthesis.
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.
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