PMID- 31598439
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231014
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 11
IP  - 8
DP  - 2019 Aug 7
TI  - Safety and Efficacy of Anterior Lumbar Interbody Fusion for Discogenic Chronic 
      Low Back Pain in a Short-stay Setting: Data From a Prospective Registry.
PG  - e5332
LID - 10.7759/cureus.5332 [doi]
LID - e5332
AB  - Introduction As a possible treatment option for chronic lower back pain (CLBP) 
      due to single-level degenerative disc disorder (DDD), the efficacy of anterior 
      lumbar interbody fusion (ALIF) has been reviewed various times in the existing 
      literature. Nevertheless, a scarcity of data exists pertaining to ALIF procedures 
      carried out in a short-stay setting using an Enhanced Recovery after Surgery 
      (ERAS) protocol, particularly concerning the safety. Methods Prospectively 
      collected data are analyzed to study the efficacy and safety of short-stay ERAS 
      ALIF in treatment of single-level DDD. Visual Analog Scale (VAS) in both back and 
      leg pain along with the Oswestry Disability Index (ODI) were used to collect 
      measure outcomes. The primary endpoint was a minimum clinically important 
      difference (MCID) of >/=30% for the ODI at 12 months. Results Forty-four patients 
      underwent surgery after failed long-term conservative treatment. MCID was 
      achieved in 78%. Age was the only significant factor in association with MCID (p 
      = 0.03), while gender, Modic changes, results of prognostic tests, prior surgery 
      and smoking status had no significant influence on either MCID or change scores 
      for any outcome measure. One complication in the form of transient new 
      radiculopathy occurred in one patient (2.3%). Conclusion With overall positive 
      outcomes in terms of both efficacy and safety, an ALIF procedure with subsequent 
      implementation of an ERAS protocol in a short-stay setting can be an option for 
      strictly selected patients with CLBP. Further study, however, possibly with a 
      larger sample size, would be necessary to substantiate these findings.
CI  - Copyright (c) 2019, Vieli et al.
FAU - Vieli, Moira
AU  - Vieli M
AD  - Neurosurgery, Bergman Clinics, Amsterdam, NLD.
FAU - Staartjes, Victor E
AU  - Staartjes VE
AD  - Neurosurgery, Bergman Clinics, Amsterdam, NLD.
FAU - Eversdjik, Hubert A J
AU  - Eversdjik HAJ
AD  - Neurosurgery, Bergman Clinics, Amsterdam, NLD.
FAU - De Wispelaere, Marlies P
AU  - De Wispelaere MP
AD  - Miscellaneous, Bergman Clinics, Amsterdam, NLD.
FAU - Oosterhuis, Jan Wolter A
AU  - Oosterhuis JWA
AD  - General Surgery, Haaglanden Medical Center, The Hague, NLD.
FAU - Schroder, Marc L
AU  - Schroder ML
AD  - Neurosurgery, Bergman Clinics, Amsterdam, NLD.
LA  - eng
PT  - Journal Article
DEP - 20190807
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC6777969
OTO - NOTNLM
OT  - alif
OT  - anterior lumbar interbody fusion
OT  - chronic low back pain
OT  - clbp
OT  - degenerative disc disease
OT  - eras
OT  - fast-track
OT  - lumbar fusion
OT  - outpatient
OT  - short stay
COIS- The authors have declared that no competing interests exist.
EDAT- 2019/10/11 06:00
MHDA- 2019/10/11 06:01
PMCR- 2019/08/07
CRDT- 2019/10/11 06:00
PHST- 2019/10/11 06:00 [entrez]
PHST- 2019/10/11 06:00 [pubmed]
PHST- 2019/10/11 06:01 [medline]
PHST- 2019/08/07 00:00 [pmc-release]
AID - 10.7759/cureus.5332 [doi]
PST - epublish
SO  - Cureus. 2019 Aug 7;11(8):e5332. doi: 10.7759/cureus.5332.