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Hybrid construct for two levels disc disease in lumbar spine

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Abstract

Prospective study. To study the validity of Hybrid construction (Anterior Lumbar Interbody Fusion) ALIF at one level and total disc arthroplasty (TDA) at adjacent, for two levels disc disease in lumbar spine as surgical strategy. With growing evidence that fusion constructs in the treatment of degenerative disc disease (DDD) may alter sagittal balance and contribute to undesirable complications in the long-term, total disc arthroplasty (TDA) slowly becomes an accepted treatment option for a selected group of patients. Despite encouraging early and intermediate term results of single-level total disc arthroplasty reported in the literature, there is growing evidence that two-level arthroplasty does not fare as well. Hybrid fusion is an attempt to address two-level DDD by combining the advantages of a single-level ALIF with those of a single-level arthroplasty. 42 patients (25 females and 17 males) underwent Hybrid fusion and had a median follow-up of 26.3 months. The primary functional outcomes were assessed before and after surgery with Oswestry Disability Index and the visual analogue score of the back and legs. Patients were divided into four groups according to the percentage improvement between preop and postop ODI scores. A total of 42 patients underwent a hybrid fusion as follows: 35 L5-S1 ALIF/L4-5 prosthesis, 3 L4-5 ALIF/L3-4 prosthesis, 2 L5-S1 ALIF/L4-5 prosthesis/L3-4 prosthesis, 1 L5-S1 prosthesis/L4-5 ALIF, and 1 L5-S1 ALIF/L4-5 ALIF/L3-4 prosthesis. At 2-years clinical outcomes, mean reduction in ODI is 24.9 points (53.0% improvement compared to preop ODI). The visual analogue score for the back is 64.6% improvement. At 2-year clinical outcomes, Hybrid fusion is a viable surgical alternative for the treatment of two-level DDD in comparison with two-level TDA and with two-level fusion.

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Authors and Affiliations

  1. CHU Bordeaux, Université Bordeaux, Spine Unit, Bordeaux, France

    Stephane Aunoble, Robert Meyrat, Yasser Al Sawad, C. Tournier, Philip Leijssen & Jean-Charles Le Huec

  2. DETERCA Surgical Lab, Université Bordeaux, 33076, Bordeaux, France

    Stephane Aunoble, Robert Meyrat, Yasser Al Sawad, C. Tournier, Philip Leijssen & Jean-Charles Le Huec

Authors
  1. Stephane Aunoble
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  2. Robert Meyrat
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  3. Yasser Al Sawad
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  4. C. Tournier
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  5. Philip Leijssen
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  6. Jean-Charles Le Huec
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Correspondence to Jean-Charles Le Huec.

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Aunoble, S., Meyrat, R., Al Sawad, Y. et al. Hybrid construct for two levels disc disease in lumbar spine. Eur Spine J 19, 290–296 (2010). https://doi.org/10.1007/s00586-009-1182-7

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  • DOI: https://doi.org/10.1007/s00586-009-1182-7

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