RT Journal Article
SR Electronic
T1 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
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 8761
DO 10.14444/8761
A1 Benites, Vinicius de Meldau
A1 Bertolini Mussalem, Matheus Galvão Valadares
A1 Baptista, Vinicius Santos
A1 Pasetti, Emanuelle Sad
A1 Gomes, Izabela Dib
A1 Desideri, Alexandre Vinhal
A1 Uehara, Milton Kiyonory
A1 Colaço Aguiar, Nuno Rodolfo
A1 Fernandes, Allison Roxo
A1 Carneiro Júnior, Francisco Cialdine Frota
A1 Dias Pereira Filho, Aécio Rubens
YR 2025
UL https://www.ijssurgery.com/content/early/2025/05/18/8761.abstract
AB 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.Level of Evidence 4.