@article {Kroeze7097, author = {RJ Kroeze and SJ Verberne and HCA Graat and K Slot and WJ Pluymakers and OPP Temmerman}, title = {Mid-Term and Long-Term Clinical and Radiological Outcomes of a Carbon I/F Stand-Alone Cage in Anterior Lumbar Interbody Fusion}, elocation-id = {7097}, year = {2020}, doi = {10.14444/7097}, publisher = {International Journal of Spine Surgery}, abstract = {Study Design: Retrospective cohort study.Objective: The current study was undertaken to determine the midterm and long-term radiological outcomes, complications and functional status of patients who underwent a single-level anterior interbody lumbar fusion (ALIF) procedure. Summary of Background Data: Low back pain affects 70\%{\textendash}90\% of the general population at some point in their life, and in general, the majority are best treated by nonsurgical therapy. However, a lumbar fusion can be considered in selected cases. In previous decades, lumbar interbody fusion procedures have gained popularity. Despite the approach used, stand-alone interbody fusion is becoming less popular due to poor fusion rates. When studying ALIF procedures, the addition of instrumentation results in higher fusion rates. Nevertheless, long-term follow-up can give either unexpected or similar insights into certain procedures that should be available in the current literature. Therefore, the current study was undertaken to determine the midterm and long-term radiological outcomes, complications, and functional status of patients who underwent a single-level ALIF procedure.Methods: A cohort of 50 patients was studied following stand-alone ALIF for midterm and long-term follow-up of 6.6 years and 19.7 years, respectively. Primary outcome measurements were disability using the Oswestry Disability Index (ODI) score and pain scores using the visual analog scale, and the MOS 36-item Short-Form Health Survey (SF-36) was used to evaluate the quality of life. In addition, radiographic assessment was performed to indicate the number of solid fusions.Results: After a mean of 19.7 years, we had a loss to follow-up of 34\%. Functional measurements revealed an ODI of 41 for both time points and an SF-36 physical component score around 41.4 and 40.8 for the midterm and long-term follow-up, respectively. The mental component of the SF-36 was 48.7 and 49.9, respectively. The assessment of interbody fusion revealed only 66\% and 70\% solid fusion after 6.6 years and 19.7 years, respectively.Conclusions: In concordance with previous studies, the outcome of midterm and long-term results in this study showed that the I/F cage in ALIF procedures is a safe treatment option for single-level interbody fusion. The radiological results corroborate literature regarding stand-alone interbody fusion, and additional instrumentation is likely to increase fusion rates. However, functional measurements reveal that the postsurgical situation remains likely worse than patients in a healthy Dutch population but possibly better that in a back pain population.}, issn = {2211-4599}, URL = {http://www.ijssurgery.com/content/early/2020/10/09/7097}, eprint = {http://www.ijssurgery.com/content/early/2020/10/09/7097.full.pdf}, journal = {International Journal of Spine Surgery} }