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Radiographic and Clinical Outcomes After Stand-Alone Anterior Lumbar Interbody Fusion for Symptomatic L5-S1
Steve S Cho1, S Harrison Farber1, Joseph D DiDomenico1
1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Operative Neurosurgery (Hagerstown, Md.)
|December 1, 2023
Summary
Stand-alone anterior lumbar interbody fusion (ALIF) effectively treated symptomatic L5-S1 retrolisthesis, improving radiographic alignment and patient-reported outcomes. This surgical approach demonstrated significant clinical benefits in patients who failed conservative management.
Area of Science:
- Spine surgery
- Orthopedics
- Neurosurgery
Background:
- Degenerative lumbar spondylolisthesis causes significant pain and disability.
- Lumbar retrolisthesis is less studied than anterolisthesis.
- Surgical outcomes for L5-S1 retrolisthesis require further investigation.
Purpose of the Study:
- To investigate surgical outcomes for symptomatic L5-S1 retrolisthesis.
- To evaluate the efficacy of stand-alone L5-S1 anterior lumbar interbody fusion (ALIF).
Main Methods:
- Retrospective analysis of 20 patients with symptomatic L5-S1 retrolisthesis.
- All patients underwent stand-alone L5-S1 ALIF after failure of nonoperative management.
- Preoperative and postoperative radiographic and patient-reported outcome measures were analyzed.
Main Results:
- Postoperative improvements observed in L5-S1 retrolisthesis, disk height, disk angle, foraminal height, L5-S1 lordosis, and lumbar lordosis.
- Significant improvements in Oswestry Disability Index, SF-36, and leg pain scores were achieved in over 50% of patients.
- All patients achieved fusion with no major complications or need for revision surgery.
Conclusions:
- Stand-alone L5-S1 ALIF is a viable surgical option for symptomatic L5-S1 retrolisthesis.
- The procedure leads to both radiographic and clinical improvements.
- This technique offers a safe and effective treatment for this specific spinal condition.
