Comparison of Different Approaches in Lumbosacral Spinal Fusion Surgery: A Systematic Review and Meta-Analysis
We aimed to systematically review the literature to analyze the differences in posterior lumbar interbody fusion (PLIF), anterior lumbar interbody fusion (ALIF), and transforaminal lumbar interbody fusion (TLIF), focusing on the complications, risk factors, and fusion rate of each approach. Spinal f...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2022-02-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2020-0405.pdf |
| _version_ | 1818979709549019136 |
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| author | Maximilian Lenz Kaliye Mohamud Jan Bredow Stavros Oikonomidis Peer Eysel Max Joseph Scheyerer |
| author_facet | Maximilian Lenz Kaliye Mohamud Jan Bredow Stavros Oikonomidis Peer Eysel Max Joseph Scheyerer |
| author_sort | Maximilian Lenz |
| collection | DOAJ |
| description | We aimed to systematically review the literature to analyze the differences in posterior lumbar interbody fusion (PLIF), anterior lumbar interbody fusion (ALIF), and transforaminal lumbar interbody fusion (TLIF), focusing on the complications, risk factors, and fusion rate of each approach. Spinal fusion surgery is a well-established surgical procedure for a variety of indications, and different approaches developed. The various approaches and their advantages, as well as approach-related pathology and complications, are well investigated in spinal surgery. Focusing only on lumbosacral fusion, the comparative studies of different approaches remain fewer in numbers. We systematically reviewed the literature on the complications associated with lumbosacral interbody fusion. Only the PLIF, ALIF, or TLIF approaches and studies published within the last decade (2007–2017) were included. The exclusion criteria in this study were oblique lumbar interbody fusion, extreme lateral interbody fusion, more than one procedure per patient, and reported patient numbers less than 10. The outcome variables were indications, fusion rates, operation time, perioperative complications, and clinical outcome by means of Visual Analog Scale, Oswestry Disability Index, and Japanese Orthopaedic Association score. Five prospective, 17 retrospective, and two comparative studies that investigated the lumbosacral region were included. Mean fusion rates were 91,4%. ALIF showed a higher operation time, while PLIF resulted in greater blood loss. In all approaches, significant improvements in the clinical outcome were achieved, with ALIF showing slightly better results. Regarding complications, the ALIF technique showed the highest complication rates. Lumbosacral fusion surgery is a treatment to provide good results either through an approach for various indications as causes of lower back pain. For each surgical approach, advantages can be depicted. However, perioperative complications and risk factors are numerous and vary with ALIF, PLIF, and TLIF procedures, as well as with fusion rates. |
| first_indexed | 2024-12-20T17:03:51Z |
| format | Article |
| id | doaj.art-8cf38619d4c941cc93e0298998aceba0 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-20T17:03:51Z |
| publishDate | 2022-02-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-8cf38619d4c941cc93e0298998aceba02022-12-21T19:32:25ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462022-02-0116114114910.31616/asj.2020.04051330Comparison of Different Approaches in Lumbosacral Spinal Fusion Surgery: A Systematic Review and Meta-AnalysisMaximilian Lenz0Kaliye Mohamud1Jan Bredow2Stavros Oikonomidis3Peer Eysel4Max Joseph Scheyerer5Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Cologne, GermanyDepartment of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Cologne, GermanyDepartment of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Cologne, GermanyDepartment of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Cologne, GermanyDepartment of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Cologne, GermanyDepartment of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Cologne, GermanyWe aimed to systematically review the literature to analyze the differences in posterior lumbar interbody fusion (PLIF), anterior lumbar interbody fusion (ALIF), and transforaminal lumbar interbody fusion (TLIF), focusing on the complications, risk factors, and fusion rate of each approach. Spinal fusion surgery is a well-established surgical procedure for a variety of indications, and different approaches developed. The various approaches and their advantages, as well as approach-related pathology and complications, are well investigated in spinal surgery. Focusing only on lumbosacral fusion, the comparative studies of different approaches remain fewer in numbers. We systematically reviewed the literature on the complications associated with lumbosacral interbody fusion. Only the PLIF, ALIF, or TLIF approaches and studies published within the last decade (2007–2017) were included. The exclusion criteria in this study were oblique lumbar interbody fusion, extreme lateral interbody fusion, more than one procedure per patient, and reported patient numbers less than 10. The outcome variables were indications, fusion rates, operation time, perioperative complications, and clinical outcome by means of Visual Analog Scale, Oswestry Disability Index, and Japanese Orthopaedic Association score. Five prospective, 17 retrospective, and two comparative studies that investigated the lumbosacral region were included. Mean fusion rates were 91,4%. ALIF showed a higher operation time, while PLIF resulted in greater blood loss. In all approaches, significant improvements in the clinical outcome were achieved, with ALIF showing slightly better results. Regarding complications, the ALIF technique showed the highest complication rates. Lumbosacral fusion surgery is a treatment to provide good results either through an approach for various indications as causes of lower back pain. For each surgical approach, advantages can be depicted. However, perioperative complications and risk factors are numerous and vary with ALIF, PLIF, and TLIF procedures, as well as with fusion rates.http://www.asianspinejournal.org/upload/pdf/asj-2020-0405.pdfl5/s1 fusionrisk factorscomplicationsposterior lumbar interbody fusiontransforaminal lumbar interbody fusionanterior lumbar interbody fusion |
| spellingShingle | Maximilian Lenz Kaliye Mohamud Jan Bredow Stavros Oikonomidis Peer Eysel Max Joseph Scheyerer Comparison of Different Approaches in Lumbosacral Spinal Fusion Surgery: A Systematic Review and Meta-Analysis Asian Spine Journal l5/s1 fusion risk factors complications posterior lumbar interbody fusion transforaminal lumbar interbody fusion anterior lumbar interbody fusion |
| title | Comparison of Different Approaches in Lumbosacral Spinal Fusion Surgery: A Systematic Review and Meta-Analysis |
| title_full | Comparison of Different Approaches in Lumbosacral Spinal Fusion Surgery: A Systematic Review and Meta-Analysis |
| title_fullStr | Comparison of Different Approaches in Lumbosacral Spinal Fusion Surgery: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Comparison of Different Approaches in Lumbosacral Spinal Fusion Surgery: A Systematic Review and Meta-Analysis |
| title_short | Comparison of Different Approaches in Lumbosacral Spinal Fusion Surgery: A Systematic Review and Meta-Analysis |
| title_sort | comparison of different approaches in lumbosacral spinal fusion surgery a systematic review and meta analysis |
| topic | l5/s1 fusion risk factors complications posterior lumbar interbody fusion transforaminal lumbar interbody fusion anterior lumbar interbody fusion |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2020-0405.pdf |
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