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Spine Tango reports less severe complications in ALIF than PLF
Anterior lumbar interbody fusion had more overall complications, but no return to surgery.
A feasibility study using data from an international spine registry shows comparable complication rates between anterior lumbar interbody fusion and instrumented posterolateral fusion, but more severe complications with instrumented posterolateral fusion.
In a dataset analysis of 39 patients treated with anterior lumbar interbody fusion (ALIF) and 296 patients treated with posterolateral fusion (PLF), investigators discovered no significant differences in the complication rates between the procedures (12.8% vs. 8.8%, respectively). While they found that sensory and motor skill disturbances were the most frequently occurring complications in the ALIF group, they discovered that all five cases for reoperation occurred in the PLF group.
“We found a lower severity of complications in the ALIF group needing confirmation by a larger patient sample,” Markus Melloh, MD, said during his presentation at the 8th European Federation of National Associations of Orthopaedics and Traumatology Congress. “Outpatient rehabilitation in the ALIF group is twice as frequent as in the PLF group, and we must confess that age may be a confounder.”
Spine Tango
The aim of the study was to determine the feasibility of gathering evidence from Spine Tango, an international spine registry that receives data from 28 clinics in nine countries.
“So far, there have only been data analyses of registry data on national levels, and this is the first pilot study on an international level,” said Melloh, who is the Spine Tango coordinator.
The study included patients with degenerative disc disease, but only 25% to 33% of the patients had prior surgery. “Very few of them had more than two spine surgeries,” Melloh said.
The investigators found that patients in the PLF group were significantly older than those in the ALIF group (64 vs. 56 years old). They also reported a 12.8% complication rate for the ALIF group and 8.8% rate for the PLF group. They found no significant correlation between age and complications, he said.
Home-based rehabilitation
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Nearly 75% of all patients underwent rehabilitation and about 50% received home-based rehab, Melloh told Orthopaedics Today International. The investigators discovered that twice as many patients in the ALIF group had outpatient rehabilitation compared to the PLF group.
“The higher percentage of patients with outpatient rehabilitation in the ALIF group may be explained by their lower age, compared with patients in the PLF group,” Melloh said.
He cited the feasibility of data analysis using Spine Tango as an advantage of the study and noted the lack of age-matched data as a limitation.
“Current limitations of Spine Tango in general include the low number and short duration of follow-ups and the lack of sufficiently detailed patient data on subgroup levels,” Melloh said. “In the near future, Spine Tango version three, with patient-based data, will make outcome evaluations possible. This will enable us to present more comprehensive analyses of Spine Tango.”
For more information:Reference:
- Markus Melloh, MD, can be reached at MEM Research Center for Orthopaedic Surgery, University of Berne, Stauffacherstrasee 78, CH-3014 Berne, Switzerland; +41-31-631-59-41; e-mail: markus.melloh@MEMcenter.unibe.ch.
- Melloh M, Staub L, Roeder C, et al. Anterior lumbar interbody fusion (ALIF) vs. Instrumented posterolateral fusion (PLF): Are there advantages for one of the two methods regarding complications and rehabilitation? #F753. Presented at the 8th European Federation of National Associations of Orthopaedics and Traumatology Congress. May 11-15, 2007. Florence.