Our Summary

This research paper is about a surgical procedure called Anterior Lumbar Interbody Fusion (ALIF), often used for treating certain spinal conditions. The authors wanted to understand how often this surgery was successful when done alone, without any additional procedures.

They searched through major medical databases for studies about this topic, excluding any that were not in English or involved animals. In total, they reviewed 840 studies, but only 55 met their criteria and were included in the review.

The 55 studies that were included involved 5,517 patients who had the ALIF procedure at 6,303 different points in their spine. They found that on average, the surgery was successful 88.2% of the time. For studies with at least 50 patients, the success rate was slightly higher at 88.6%.

They also found that using a device called an anterior fixation plate improved the success rate to 94.2%, and a newer device called a zero-profile interbody implant had a success rate of 89.2%.

Interestingly, the success rate was lower in studies where half or more of the patients were smokers or had workers’ compensation. However, these results were not statistically significant, meaning they could have been due to chance.

Finally, they found that using a substance called rhBMP-2 improved the success rate to 94.4%, compared to 84.8% without it.

The authors conclude that the ALIF procedure is often successful when done alone, but the success rate is higher when certain devices or substances are used. They also found that the success rate may be lower among smokers and those with workers’ compensation, but more research is needed to confirm these findings.

FAQs

  1. What is the average success rate of the Anterior Lumbar Interbody Fusion (ALIF) procedure when performed alone?
  2. How can the success rate of the ALIF procedure be improved according to the research?
  3. Did the study find any factors that could potentially lower the success rate of the ALIF procedure?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal fusion, specifically ALIF, is that the procedure can be successful in treating certain spinal conditions, but the success rate may be improved with the use of specific devices or substances. Patients who are smokers or have workers’ compensation may have a slightly lower success rate, but further research is needed to confirm these findings. It’s important to discuss all options and potential risks with your healthcare provider before undergoing spinal fusion surgery.

Suitable For

Patients who are typically recommended for spinal fusion procedures such as ALIF include those with:

  1. Degenerative disc disease: This condition occurs when the discs between the vertebrae in the spine break down, leading to pain and reduced mobility.

  2. Spondylolisthesis: This is a condition where one vertebra slips forward over the one below it, causing back pain and nerve compression.

  3. Spinal stenosis: This is a narrowing of the spinal canal, which can put pressure on the spinal cord and nerves, leading to pain and numbness.

  4. Herniated disc: When the gel-like center of a spinal disc pushes out through a tear in the outer layer, it can cause pain and nerve compression.

  5. Spinal fractures: Fractures in the vertebrae due to trauma or osteoporosis can sometimes be treated with spinal fusion to stabilize the spine.

  6. Failed previous spinal surgery: Patients who have not had success with other treatments may be recommended for spinal fusion to address ongoing pain and instability.

Overall, patients who have tried non-surgical treatments for their spinal condition and have not found relief may be considered for spinal fusion surgery as a last resort to improve their symptoms and quality of life.

Timeline

Before the spinal fusion procedure:

  • Patient undergoes a thorough evaluation by a spine specialist to determine if spinal fusion is necessary
  • Patient may undergo imaging tests such as X-rays, CT scans, or MRI scans to assess the condition of their spine
  • Patient may try non-surgical treatments such as physical therapy, medications, or injections to relieve symptoms
  • Patient discusses the risks and benefits of the procedure with their healthcare provider
  • Patient undergoes pre-operative preparation and may need to stop certain medications or adjust their diet

After the spinal fusion procedure:

  • Patient is closely monitored in the hospital for a few days after the surgery
  • Patient may experience pain and discomfort at the surgical site, which can be managed with pain medications
  • Patient may need to wear a brace or use assistive devices to support their spine as it heals
  • Patient undergoes physical therapy to regain strength and mobility in the spine
  • Patient follows a personalized rehabilitation plan to ensure proper healing and prevent complications
  • Patient attends follow-up appointments with their healthcare provider to monitor their progress and address any concerns or complications

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal fusion, specifically the ALIF procedure, include:

  1. What is the success rate of the ALIF procedure for my specific spinal condition?
  2. Are there any additional devices or substances that can be used during the surgery to improve the success rate?
  3. How does smoking or having workers’ compensation affect the success rate of the procedure?
  4. Are there any potential complications or risks associated with the ALIF procedure?
  5. What is the recovery process like after undergoing the ALIF procedure?
  6. How long will it take for me to fully recover and return to normal activities?
  7. Are there any alternative treatment options to consider before undergoing spinal fusion surgery?
  8. How many ALIF procedures have you performed, and what is your experience with this specific surgery?
  9. What can I do to prepare for the surgery and optimize my chances of a successful outcome?
  10. Are there any lifestyle changes I should make before or after the surgery to improve the results of the procedure?

Reference

Authors: Manzur M, Virk SS, Jivanelli B, Vaishnav AS, McAnany SJ, Albert TJ, Iyer S, Gang CH, Qureshi S. Journal: Spine J. 2019 Jul;19(7):1294-1301. doi: 10.1016/j.spinee.2019.03.001. Epub 2019 Mar 11. PMID: 30872148