Vinicius de Meldau Benites, Matheus Galvão Valadares Bertolini Mussalem, Vinicius Santos Baptista, Emanuelle Sad Pasetti, Izabela Dib Gomes, Alexandre Vinhal Desideri, Milton Kiyonory Uehara, Nuno Rodolfo Colaço Aguiar, Allison Roxo Fernandes, Francisco Cialdine Frota Carneiro Júnior, Aécio Rubens Dias Pereira Filho
{"title":"独立前路腰椎椎体间融合术、360°前路腰椎椎体间融合术和关节成形术治疗复发性腰椎间盘突出症的比较：重点关注神经减压和疼痛性脊柱不稳定的解决。","authors":"Vinicius de Meldau Benites, Matheus Galvão Valadares Bertolini Mussalem, Vinicius Santos Baptista, Emanuelle Sad Pasetti, Izabela Dib Gomes, Alexandre Vinhal Desideri, Milton Kiyonory Uehara, Nuno Rodolfo Colaço Aguiar, Allison Roxo Fernandes, Francisco Cialdine Frota Carneiro Júnior, Aécio Rubens Dias Pereira Filho","doi":"10.14444/8761","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Currently, there are no studies in the literature that specifically compare stand-alone anterior lumbar interbody fusion (ALIF), 360° ALIF, or arthroplasty in patients with recurrent lumbar disc herniation presenting with signs of instability. Thus, the authors sought to fill this knowledge gap by comparing intraoperative and short-term postoperative outcomes of patients with recurrent lumbar disc herniation and signs of instability undergoing stand-alone ALIF), 360° ALIF, or arthroplasty.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a single center from August 2019 to January 2024. Inclusion criteria included patients older than 18 years diagnosed with recurrent lumbar disc herniation and signs of instability undergoing stand-alone ALIF, 360° ALIF, or arthroplasty. Exclusion criteria were incomplete data or other indications. Data collected included demographics, surgical specifics (procedure type, operated levels, graft type, and incision type), and clinical outcomes (intraoperative morbidity and short-term postoperative outcomes).</p><p><strong>Results: </strong>Sixty-five patients were evaluated. No intraoperative complications occurred in any group. Mean operative times were 165.8 ± 61.72 minutes for stand-alone ALIF, 236.25 ± 46.3 minutes for 360° ALIF, and 98.43 ± 45 minutes for arthroplasty (<i>P</i> < 0.0001). The mean postoperative hospital stay was 2.46 ± 1.14 days, with no significant difference between groups (<i>P</i> = 0.515). Postoperative complications were minimal: 1 surgical site infection in the stand-alone ALIF group (<i>P</i> = 0.444) and 4 instances of sympathetic changes (<i>P</i> = 0.477), with 1 occurring in the stand-alone ALIF group, 1 in the 360° ALIF group, and 2 in the arthroplasty group. There was no statistical difference between the groups in relation to the visual analog scale and Oswestry Disability Index scores.</p><p><strong>Conclusion: </strong>There was no significant difference in intraoperative morbidity, short-term postoperative outcomes, or length of stay among the 3 groups. All techniques demonstrated good results with low morbidity and short hospitalizations, suggesting that the choice of technique should be based on the surgeon's experience and the patient's condition and preferences.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of Stand-Alone Anterior Lumbar Interbody Fusion, 360° Anterior Lumbar Interbody Fusion, and Arthroplasty for Recurrent Lumbar Disc Herniation: Focus on Nerve Decompression and Painful Spinal Instability Resolution.\",\"authors\":\"Vinicius de Meldau Benites, Matheus Galvão Valadares Bertolini Mussalem, Vinicius Santos Baptista, Emanuelle Sad Pasetti, Izabela Dib Gomes, Alexandre Vinhal Desideri, Milton Kiyonory Uehara, Nuno Rodolfo Colaço Aguiar, Allison Roxo Fernandes, Francisco Cialdine Frota Carneiro Júnior, Aécio Rubens Dias Pereira Filho\",\"doi\":\"10.14444/8761\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Currently, there are no studies in the literature that specifically compare stand-alone anterior lumbar interbody fusion (ALIF), 360° ALIF, or arthroplasty in patients with recurrent lumbar disc herniation presenting with signs of instability. Thus, the authors sought to fill this knowledge gap by comparing intraoperative and short-term postoperative outcomes of patients with recurrent lumbar disc herniation and signs of instability undergoing stand-alone ALIF), 360° ALIF, or arthroplasty.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a single center from August 2019 to January 2024. Inclusion criteria included patients older than 18 years diagnosed with recurrent lumbar disc herniation and signs of instability undergoing stand-alone ALIF, 360° ALIF, or arthroplasty. Exclusion criteria were incomplete data or other indications. Data collected included demographics, surgical specifics (procedure type, operated levels, graft type, and incision type), and clinical outcomes (intraoperative morbidity and short-term postoperative outcomes).</p><p><strong>Results: </strong>Sixty-five patients were evaluated. No intraoperative complications occurred in any group. Mean operative times were 165.8 ± 61.72 minutes for stand-alone ALIF, 236.25 ± 46.3 minutes for 360° ALIF, and 98.43 ± 45 minutes for arthroplasty (<i>P</i> < 0.0001). The mean postoperative hospital stay was 2.46 ± 1.14 days, with no significant difference between groups (<i>P</i> = 0.515). Postoperative complications were minimal: 1 surgical site infection in the stand-alone ALIF group (<i>P</i> = 0.444) and 4 instances of sympathetic changes (<i>P</i> = 0.477), with 1 occurring in the stand-alone ALIF group, 1 in the 360° ALIF group, and 2 in the arthroplasty group. There was no statistical difference between the groups in relation to the visual analog scale and Oswestry Disability Index scores.</p><p><strong>Conclusion: </strong>There was no significant difference in intraoperative morbidity, short-term postoperative outcomes, or length of stay among the 3 groups. All techniques demonstrated good results with low morbidity and short hospitalizations, suggesting that the choice of technique should be based on the surgeon's experience and the patient's condition and preferences.</p><p><strong>Level of evidence: 4: </strong></p>\",\"PeriodicalId\":38486,\"journal\":{\"name\":\"International Journal of Spine Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-05-19\",\"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/10.14444/8761\",\"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/10.14444/8761","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Comparison of Stand-Alone Anterior Lumbar Interbody Fusion, 360° Anterior Lumbar Interbody Fusion, and Arthroplasty for Recurrent Lumbar Disc Herniation: Focus on Nerve Decompression and Painful Spinal Instability Resolution.
Background: Currently, there are no studies in the literature that specifically compare stand-alone anterior lumbar interbody fusion (ALIF), 360° ALIF, or arthroplasty in patients with recurrent lumbar disc herniation presenting with signs of instability. Thus, the authors sought to fill this knowledge gap by comparing intraoperative and short-term postoperative outcomes of patients with recurrent lumbar disc herniation and signs of instability undergoing stand-alone ALIF), 360° ALIF, or arthroplasty.
Methods: This retrospective cohort study was conducted at a single center from August 2019 to January 2024. Inclusion criteria included patients older than 18 years diagnosed with recurrent lumbar disc herniation and signs of instability undergoing stand-alone ALIF, 360° ALIF, or arthroplasty. Exclusion criteria were incomplete data or other indications. Data collected included demographics, surgical specifics (procedure type, operated levels, graft type, and incision type), and clinical outcomes (intraoperative morbidity and short-term postoperative outcomes).
Results: Sixty-five patients were evaluated. No intraoperative complications occurred in any group. Mean operative times were 165.8 ± 61.72 minutes for stand-alone ALIF, 236.25 ± 46.3 minutes for 360° ALIF, and 98.43 ± 45 minutes for arthroplasty (P < 0.0001). The mean postoperative hospital stay was 2.46 ± 1.14 days, with no significant difference between groups (P = 0.515). Postoperative complications were minimal: 1 surgical site infection in the stand-alone ALIF group (P = 0.444) and 4 instances of sympathetic changes (P = 0.477), with 1 occurring in the stand-alone ALIF group, 1 in the 360° ALIF group, and 2 in the arthroplasty group. There was no statistical difference between the groups in relation to the visual analog scale and Oswestry Disability Index scores.
Conclusion: There was no significant difference in intraoperative morbidity, short-term postoperative outcomes, or length of stay among the 3 groups. All techniques demonstrated good results with low morbidity and short hospitalizations, suggesting that the choice of technique should be based on the surgeon's experience and the patient's condition and preferences.
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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