RT Journal Article
SR Electronic
T1 Safety and Viability of Anterior Lumbar Interbody Fusion in Complex Revision Lumbar Spine Surgeries: Insights From a Case Series of 135 Patients on Transforaminal Lumbar Interbody Fusion/Posterior Lumbar Interbody Fusion Cage Removal
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 8753
DO 10.14444/8753
A1 Dias Pereira Filho, Aécio Rubens
A1 Bertolini Mussalem, Matheus Galvão Valadares
A1 Baptista, Vinicius Santos
A1 Benites, Vinicius de Meldau
A1 Uehara, Milton Kiyonory
A1 Colaço Aguiar, Nuno Rodolfo
A1 Baston, Arthur Cristiano
A1 Desideri, Alexandre Vinhal
A1 Frota Carneiro Júnior, Francisco Cialdine
YR 2025
UL https://www.ijssurgery.com/content/early/2025/04/17/8753.abstract
AB Background Anterior lumbar interbody fusion (ALIF) has emerged as a valuable technique for managing lumbar degenerative conditions and revision surgeries, particularly for addressing complications associated with transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) cages. However, there is limited evidence documenting its safety and feasibility in the context of revision procedures involving cage removal.Objective To evaluate intraoperative outcomes of ALIF for TLIF/PLIF cage removal, focusing on complications, surgical times, and blood loss in a substantial case series.Methods This case series analyzed data from 135 patients who underwent ALIF for TLIF/PLIF cage removal between January 2019 and May 2023. Surgical indications included pseudarthrosis, cage migration, and infection. Outcomes assessed included intraoperative complications, surgical duration, and estimated blood loss.Results Of the 135 patients (median age: 47 years, range: 15–78), vascular injuries occurred in only 4 cases, all involving the left iliac vein, and were managed intraoperatively without sequelae. No injuries to retroperitoneal, neural, or organ structures were observed. Median surgical time was 100 minutes (range: 50–210), with most cases resulting in less than 150 mL of blood loss. These findings demonstrate the feasibility of ALIF for managing TLIF/PLIF complications.Conclusion ALIF is a safe and effective option for revision surgeries involving TLIF/PLIF cage removal, offering a low complication profile and manageable intraoperative challenges. A critical factor contributing to these favorable outcomes is the multidisciplinary approach, where the collaboration between access and spine surgeons ensures meticulous handling of anatomical and vascular challenges.Clinical Relevance This study provides valuable data for further prospective research to explore long-term outcomes and refine surgical techniques.Level of Evidence 4.