Endoscopic Anterior Lumbar Interbody Fusion: Systematic Review and Meta-Analysis
Laparoscopic anterior lumbar interbody fusion (L-ALIF), which employs laparoscopic cameras to facilitate a less invasive approach, originally gained traction during the 1990s but has subsequently fallen out of favor. As the envelope for endoscopic approaches continues to be pushed, a recurrence of i...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Spine Society
2023-12-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://asianspinejournal.org/upload/pdf/asj-2023-0135.pdf |
| _version_ | 1797370404182949888 |
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| author | Nolan J. Brown Zach Pennington Cathleen C. Kuo Alexander M. Lopez Bryce Picton Sean Solomon Oanh T. Nguyen Chenyi Yang Evelyne K. Tantry Hania Shahin Julian Gendreau Stephen Albano Martin H. Pham Michael Y. Oh |
| author_facet | Nolan J. Brown Zach Pennington Cathleen C. Kuo Alexander M. Lopez Bryce Picton Sean Solomon Oanh T. Nguyen Chenyi Yang Evelyne K. Tantry Hania Shahin Julian Gendreau Stephen Albano Martin H. Pham Michael Y. Oh |
| author_sort | Nolan J. Brown |
| collection | DOAJ |
| description | Laparoscopic anterior lumbar interbody fusion (L-ALIF), which employs laparoscopic cameras to facilitate a less invasive approach, originally gained traction during the 1990s but has subsequently fallen out of favor. As the envelope for endoscopic approaches continues to be pushed, a recurrence of interest in laparoscopic and/or endoscopic anterior approaches seems possible. Therefore, evaluating the current evidence base in regard to this approach is of much clinical relevance. To this end, a systematic literature search was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the following keywords: “(laparoscopic OR endoscopic) AND (anterior AND lumbar).” Out of the 441 articles retrieved, 22 were selected for quantitative analysis. The primary outcome of interest was the radiographic fusion rate. The secondary outcome was the incidence of perioperative complications. Meta-analysis was performed using RStudio’s “metafor” package. Of the 1,079 included patients (mean age, 41.8±2.9 years), 481 were males (44.6%). The most common indication for L-ALIF surgery was degenerative disk disease (reported by 18 studies, 81.8%). The mean follow-up duration was 18.8±11.2 months (range, 6–43 months). The pooled fusion rate was 78.9% (95% confidence interval [CI], 68.9–90.4). Complications occurred in 19.2% (95% CI, 13.4–27.4) of L-ALIF cases. Additionally, 7.2% (95% CI, 4.6–11.4) of patients required conversion from L-ALIF to open surgery. Although L-ALIF does not appear to be supported by studies available in the literature, it is important to consider the context from which these results have been obtained. Even if these results are taken at face value, the failure of endoscopy to have a role in the ALIF approach does not mean that it should not be incorporated in posterior approaches. |
| first_indexed | 2024-03-08T18:00:57Z |
| format | Article |
| id | doaj.art-1b167287f15649f58959d69d75975557 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-03-08T18:00:57Z |
| publishDate | 2023-12-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-1b167287f15649f58959d69d759755572024-01-02T01:14:20ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462023-12-011761139115410.31616/asj.2023.01351586Endoscopic Anterior Lumbar Interbody Fusion: Systematic Review and Meta-AnalysisNolan J. Brown0Zach Pennington1Cathleen C. Kuo2Alexander M. Lopez3Bryce Picton4Sean Solomon5Oanh T. Nguyen6Chenyi Yang7Evelyne K. Tantry8Hania Shahin9Julian Gendreau10Stephen Albano11Martin H. Pham12Michael Y. Oh13 Department of Neurosurgery, University of California, Irvine, Orange, CA, USA Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA Department of Neurosurgery, University at Buffalo, Buffalo, NY, USA Department of Neurosurgery, University of California, Irvine, Orange, CA, USA Department of Neurosurgery, University of California, Irvine, Orange, CA, USA Department of Neurosurgery, University of California, Irvine, Orange, CA, USA Department of Neurosurgery, University of California, Irvine, Orange, CA, USA Department of Neurosurgery, University of California, Irvine, Orange, CA, USA Baylor College of Medicine, Houston, TX, USA Department of Neurosurgery, University of California, Irvine, Orange, CA, USA Johns Hopkins Whiting School of Engineering, Baltimore, MD, USA Department of Neurosurgery, University of California, Irvine, Orange, CA, USA Department of Neurosurgery, University of California, San Diego, La Jolla, CA, USA Department of Neurosurgery, University of California, Irvine, Orange, CA, USALaparoscopic anterior lumbar interbody fusion (L-ALIF), which employs laparoscopic cameras to facilitate a less invasive approach, originally gained traction during the 1990s but has subsequently fallen out of favor. As the envelope for endoscopic approaches continues to be pushed, a recurrence of interest in laparoscopic and/or endoscopic anterior approaches seems possible. Therefore, evaluating the current evidence base in regard to this approach is of much clinical relevance. To this end, a systematic literature search was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the following keywords: “(laparoscopic OR endoscopic) AND (anterior AND lumbar).” Out of the 441 articles retrieved, 22 were selected for quantitative analysis. The primary outcome of interest was the radiographic fusion rate. The secondary outcome was the incidence of perioperative complications. Meta-analysis was performed using RStudio’s “metafor” package. Of the 1,079 included patients (mean age, 41.8±2.9 years), 481 were males (44.6%). The most common indication for L-ALIF surgery was degenerative disk disease (reported by 18 studies, 81.8%). The mean follow-up duration was 18.8±11.2 months (range, 6–43 months). The pooled fusion rate was 78.9% (95% confidence interval [CI], 68.9–90.4). Complications occurred in 19.2% (95% CI, 13.4–27.4) of L-ALIF cases. Additionally, 7.2% (95% CI, 4.6–11.4) of patients required conversion from L-ALIF to open surgery. Although L-ALIF does not appear to be supported by studies available in the literature, it is important to consider the context from which these results have been obtained. Even if these results are taken at face value, the failure of endoscopy to have a role in the ALIF approach does not mean that it should not be incorporated in posterior approaches.http://asianspinejournal.org/upload/pdf/asj-2023-0135.pdfmeurosurgeryspine surgeryendoscopylaparoscopyinterbody fusionanterior lumbar interbody fusionlumbar spinetransperitoneal approachretroperitoneal approacharthrodesis |
| spellingShingle | Nolan J. Brown Zach Pennington Cathleen C. Kuo Alexander M. Lopez Bryce Picton Sean Solomon Oanh T. Nguyen Chenyi Yang Evelyne K. Tantry Hania Shahin Julian Gendreau Stephen Albano Martin H. Pham Michael Y. Oh Endoscopic Anterior Lumbar Interbody Fusion: Systematic Review and Meta-Analysis Asian Spine Journal meurosurgery spine surgery endoscopy laparoscopy interbody fusion anterior lumbar interbody fusion lumbar spine transperitoneal approach retroperitoneal approach arthrodesis |
| title | Endoscopic Anterior Lumbar Interbody Fusion: Systematic Review and Meta-Analysis |
| title_full | Endoscopic Anterior Lumbar Interbody Fusion: Systematic Review and Meta-Analysis |
| title_fullStr | Endoscopic Anterior Lumbar Interbody Fusion: Systematic Review and Meta-Analysis |
| title_full_unstemmed | Endoscopic Anterior Lumbar Interbody Fusion: Systematic Review and Meta-Analysis |
| title_short | Endoscopic Anterior Lumbar Interbody Fusion: Systematic Review and Meta-Analysis |
| title_sort | endoscopic anterior lumbar interbody fusion systematic review and meta analysis |
| topic | meurosurgery spine surgery endoscopy laparoscopy interbody fusion anterior lumbar interbody fusion lumbar spine transperitoneal approach retroperitoneal approach arthrodesis |
| url | http://asianspinejournal.org/upload/pdf/asj-2023-0135.pdf |
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