Stand-alone ALIF yielded good outcomes for patients with symptomatic disc degeneration
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Published results showed stand-alone anterior lumbar interbody fusion improved outcomes and reduced back and leg pain without the need for posterior fixation in patients with symptomatic disc degeneration.
Richard D. Guyer, MD, and colleagues analyzed 58 consecutive patients (mean age of 47.8 years) who underwent ALIF using a stand-alone ALIF cage [STALIF M-Ti, Centinel Spine] with graft for symptomatic disc degeneration from March 2011 to December 2018. Outcome measures included Oswestry Disability Index (ODI), VAS back and leg pain scores and reoperations, according to the study.
At a mean follow-up of 30.6 months, Guyer and colleagues found statistically significant improvements in mean ODI scores, which decreased from 41.7 preoperatively to 21 at final follow-up, and VAS back pain and leg pain, which decreased from 6 to 2.5 and from 4.1 to 1.3, respectively. Researchers noted mean operative blood loss was 52.1 mL, and nine patients required reoperation for pseudoarthrosis (n = 3), cage subsidence (n = 1), foraminal stenosis (n = 1), metal allergy reaction (n = 2), adjacent segment degeneration (n = 1) and ongoing pain (n = 1). They also noted no cases of device failure, vertebral body fracture or screws backing out of the implant, according to the study.
“When evaluating the literature on stand-alone cages, one must use caution and keep in mind that there has been a wide variety of cage designs and materials described, many of which are no longer on the market and have been replaced with new designs incorporating intricate 3D-printed titanium cages or polyetheretherketone (PEEK) with titanium endplates,” Guyer and colleagues wrote in the study. “Some devices have integrated screws, others incorporate an exterior-anterior plate attached to the cage, and others have no anchoring screws. Much research is needed to optimize indications for each of these device types and/or compare their outcomes,” they concluded.
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