Time Course of Functional Recovery Following Single-Level Anterior Lumbar Interbody Fusion with and Without Posterior...

Area of Science:

• Spine surgery
• Orthopedics
• Neurosurgery

Background:

• Anterior lumbar interbody fusion (ALIF) is a common procedure for degenerative lumbar spine conditions.
• Postoperative recovery timelines for ALIF are not well-established, impacting patient expectations and care.
• Understanding recovery trends is crucial for optimizing patient outcomes.

Purpose of the Study:

• To define the temporal recovery trends after primary, single-level ALIF.
• To compare recovery between stand-alone (SA) and percutaneous posterior instrumentation (PI) techniques.
• To establish benchmarks for functional recovery and return to activity.

Main Methods:

• Retrospective single-institution study of 143 patients undergoing ALIF (90 SA, 53 PI).
• Assessment of patient-reported outcome measures (PROMs) including Oswestry Disability Index (ODI), Visual Analog Scale (VAS) for pain, and SF-12 Physical Component Score (PCS).
• Data collected preoperatively and at multiple time points up to 2 years postoperatively.

Main Results:

• Significant improvements in PROMs were observed through 1 year post-surgery.
• Back pain (VAS-back) improved by 2 weeks; disability (ODI) and physical function (SF-12 PCS) improved after 6 weeks.
• Over 50% achieved minimum clinically important difference (MCID) by 6 months, with continued gains through 1 year. Recovery was comparable between SA and PI groups.

Conclusions:

• This study provides time-specific recovery benchmarks for ALIF surgery.
• Findings can guide surgical decision-making and patient education regarding recovery expectations.
• Established benchmarks aid in optimizing postoperative care and managing patient expectations for functional milestones.