ALIF led to greater segmental lordosis at lumbosacral junction vs axial lumbar interbody fusion

NEW ORLEANS — Better sagittal correction of adult spinal deformity and more favorable segmental lordosis were achieved when anterior lumbar interbody fusion was performed at the bottom of a long spinal construct compared to axial lumbar interbody fusion, an investigator said at the American Academy of Orthopaedic Surgeons Annual Meeting.

Alisa Alayan, MD, and her colleagues studied 94 adults with spinal deformity treated with circumferential minimally invasive fusion at L5-S-1 at the end of a long spine fusion that involved three or more levels. Anterior lumbar interbody fusion (ALIF) was performed in 38 patients and AxiaLIF (TranS1), otherwise known as axial lumbar interbody fusion, was performed in 56 patients. Patients were followed up for a minimum of 2 years.

“Compared to AxiaLIF patients, ALIF patients had more favorable outcomes with regard to radiographic correction parameters. They had lower rates of pseudarthrosis, complications and reoperations, and hence, we conclude that ALIF is the preferred strategy for L5-S1 arthrodesis at the bottom of a long construct with circumferential minimally invasive surgery for adult spinal deformity,” Alayan said.

Segmental lordosis at follow-up was 18.23° in the ALIF group compared to 9.53° in the AxiaLIF group.

Alayan said there were six cases of pseudarthrosis in the entire cohort, five of which occurred in the AxiaLIF group. – by Susan M. Rapp

Reference:

Alayan A, et al. Paper #56. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 6-10, 2018; New Orleans.

Disclosure: Alayan reports she receives research support from Acumed LLC.