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Which procedure is better for lumbar interbody fusion: anterior lumbar interbody fusion or transforaminal lumbar interbody fusion?

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Both anterior lumbar interbody fusion (ALIF) and transforaminal lumbar interbody fusion (TLIF) surgeries are performed to obtain a solid fusion to treat lumbar spondylosis. This systematic review investigated whether surgical complications, nonfusion rate, radiographic outcome, and clinical outcome of ALIF were significantly different from those of TLIF.

Method

A computerized search of the electronic databases MEDLINE was conducted. Only therapeutic studies with a prospective or retrospective comparative design were considered for inclusion in the present investigation. Two reviewers independently extracted relevant data from each included study. Statistical comparisons were made when appropriate.

Results

Nine studies were determined to be appropriate for the systematic review, and all studies were retrospective comparative studies. Blood loss and operative time in ALIF was greater than in TLIF. There was no significant difference in the complication rate between ALIF and TLIF. The restoration of disc height, segmental lordosis, and whole lumbar lordosis in ALIF was superior to TLIF. However, clinical outcomes in ALIF were similar with TLIF, and there was no significant difference in nonfusion rate between the two techniques. Costs of ALIF were greater than those of TLIF.

Conclusion

Clinical outcomes and nonfusion rate in ALIF were similar to TLIF. However, the restoration of disc height, segmental lordosis, and whole lumbar lordosis in ALIF were superior to those in TLIF, while blood loss, operative time, and costs in ALIF were greater than in TLIF.

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References

  1. Godde S, Fritsch E, Dienst M, Kohn D (2003) Influence of cage geometry on sagittal alignment in instrumented posterior lumbar interbody fusion. Spine 28:1693–1699

    PubMed  Google Scholar 

  2. Kim NH, Lee JW (1999) Anterior interbody fusion versus posterolateral fusion with transpedicular fixation for isthmic spondylolisthesis in adults. A comparison of clinical results. Spine 24:812–816

    Article  PubMed  CAS  Google Scholar 

  3. Hackenberg L, Halm H, Bullmann V, Vieth V, Schneider M, Liljenqvist U (2005) Transforaminal lumbar interbody fusion: a safe technique with satisfactory three to five year results. Eur Spine J 14:551–558

    Article  PubMed  Google Scholar 

  4. Niemeyer TK, Koriller M, Claes L, Kettler A, Werner K, Wilke HJ (2006) In vitro study of biomechanical behavior of anterior and transforaminal lumbar interbody instrumentation techniques. Neurosurgery 59:1271–1276

    Article  PubMed  Google Scholar 

  5. Ploumis A, Wu C, Fischer G, Mehbod AA, Wu W, Faundez A, Transfeldt EE (2008) Biomechanical comparison of anterior lumbar interbody fusion and transforaminal lumbar interbody fusion. J Spinal Disord Tech 21:120–125

    Article  PubMed  Google Scholar 

  6. Potter BK, Freedman BA, Verwiebe EG, Hall JM, Polly DW Jr, Kuklo TR (2005) Transforaminal lumbar interbody fusion: clinical and radiographic results and complications in 100 consecutive patients. J Spinal Disord Tech 18:337–346

    Article  PubMed  Google Scholar 

  7. Southwick WO, Robinson RA (1957) Surgical approaches to the vertebral bodies in the cervical and lumbar regions. J Bone Joint Surg Am 39-A:631–644

    PubMed  CAS  Google Scholar 

  8. Ishihara H, Osada R, Kanamori M, Kawaguchi Y, Ohmori K, Kimura T, Matsui H, Tsuji H (2001) Minimum 10-year follow-up study of anterior lumbar interbody fusion for isthmic spondylolisthesis. J Spinal Disord 14:91–99

    Article  PubMed  CAS  Google Scholar 

  9. Lee SH, Choi WG, Lim SR, Kang HY, Shin SW (2004) Minimally invasive anterior lumbar interbody fusion followed by percutaneous pedicle screw fixation for isthmic spondylolisthesis. Spine J 4:644–649

    Article  PubMed  Google Scholar 

  10. Hacker RJ (1997) Comparison of interbody fusion approaches for disabling low back pain. Spine 22:660–665

    Article  PubMed  CAS  Google Scholar 

  11. Ray CD (1997) Threaded fusion cages for lumbar interbody fusions. An economic comparison with 360 degrees fusions. Spine 22:681–685

    Article  PubMed  CAS  Google Scholar 

  12. Hee HT, Castro FP Jr, Majd ME, Holt RT, Myers L (2001) Anterior/posterior lumbar fusion versus transforaminal lumbar interbody fusion: analysis of complications and predictive factors. J Spinal Disord 14:533–540

    Article  PubMed  CAS  Google Scholar 

  13. Whitecloud TS 3rd, Roesch WW, Ricciardi JE (2001) Transforaminal interbody fusion versus anterior–posterior interbody fusion of the lumbar spine: a financial analysis. J Spinal Disord 14:100–103

    Article  PubMed  Google Scholar 

  14. Villavicencio AT, Burneikiene S, Bulsara KR, Thramann JJ (2006) Perioperative complications in transforaminal lumbar interbody fusion versus anterior–posterior reconstruction for lumbar disc degeneration and instability. J Spinal Disord Tech 19:92–97

    Article  PubMed  Google Scholar 

  15. Hsieh PC, Koski TR, O’Shaughnessy BA, Sugrue P, Salehi S, Ondra S, Liu JC (2007) Anterior lumbar interbody fusion in comparison with transforaminal lumbar interbody fusion: implications for the restoration of foraminal height, local disc angle, lumbar lordosis, and sagittal balance. J Neurosurg Spine 7:379–386

    Article  PubMed  Google Scholar 

  16. Faundez AA, Schwender JD, Safriel Y, Gilbert TJ, Mehbod AA, Denis F, Transfeldt EE, Wroblewski JM (2009) Clinical and radiological outcome of anterior–posterior fusion versus transforaminal lumbar interbody fusion for symptomatic disc degeneration: a retrospective comparative study of 133 patients. Eur Spine J 18:203–211

    Article  PubMed  Google Scholar 

  17. Kim JS, Kang BU, Lee SH, Jung B, Choi YG, Jeon SH, Lee HY (2009) Mini-transforaminal lumbar interbody fusion versus anterior lumbar interbody fusion augmented by percutaneous pedicle screw fixation: a comparison of surgical outcomes in adult low-grade isthmic spondylolisthesis. J Spinal Disord Tech 22:114–121

    Article  PubMed  Google Scholar 

  18. Kim JS, Lee KY, Lee SH, Lee HY (2010) Which lumbar interbody fusion technique is better in terms of level for the treatment of unstable isthmic spondylolisthesis? J Neurosurg Spine 12:171–177

    Article  PubMed  Google Scholar 

  19. Burkus JK, Gornet MF, Dickman CA, Zdeblick TA (2002) Anterior lumbar interbody fusion using rhBMP-2 with tapered interbody cages. J Spinal Disord Tech 15:337–349

    Article  PubMed  Google Scholar 

  20. McAfee PC, DeVine JG, Chaput CD, Prybis BG, Fedder IL, Cunningham BW, Farrell DJ, Hess SJ, Vigna FE (2005) The indications for interbody fusion cages in the treatment of spondylolisthesis: analysis of 120 cases. Spine 30:S60–S65

    Article  PubMed  Google Scholar 

  21. Pavlov PW, Meijers H, van Limbeek J, Jacobs WC, Lemmens JA, Obradov-Rajic M, de Kleuver M (2004) Good outcome and restoration of lordosis after anterior lumbar interbody fusion with additional posterior fixation. Spine 29:1893–1899

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China

    Sheng-Dan Jiang, Jiang-Wei Chen & Lei-Sheng Jiang

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  1. Sheng-Dan Jiang
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  2. Jiang-Wei Chen
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Correspondence to Lei-Sheng Jiang.

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Jiang, SD., Chen, JW. & Jiang, LS. Which procedure is better for lumbar interbody fusion: anterior lumbar interbody fusion or transforaminal lumbar interbody fusion?. Arch Orthop Trauma Surg 132, 1259–1266 (2012). https://doi.org/10.1007/s00402-012-1546-z

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  • DOI: https://doi.org/10.1007/s00402-012-1546-z

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