PMID- 35989506
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230504
IS  - 1976-1902 (Print)
IS  - 1976-7846 (Electronic)
IS  - 1976-1902 (Linking)
VI  - 17
IP  - 2
DP  - 2023 Apr
TI  - Single-Level Anterior Lumbar Interbody Fusion versus Minimally Invasive 
      Transforaminal Lumbar Interbody Fusion at L5/S1 for an Obese Population.
PG  - 293-303
LID - 10.31616/asj.2022.0071 [doi]
AB  - STUDY DESIGN: Retrospective study. PURPOSE: To compare perioperative outcomes, 
      patient-reported outcome measures (PROMs), and minimal clinically important 
      difference (MCID) achievement rates for an obese patient cohort between 
      single-level minimally invasive (MIS) transforaminal lumbar interbody fusion 
      (TLIF) vs. anterior lumbar interbody fusion (ALIF). OVERVIEW OF LITERATURE: To 
      the best of our knowledge, no study has compared the outcomes of MIS TLIF and 
      ALIF in an obese population. METHODS: Obese patients (body mass index [BMI] >/=30.0 
      kg/m2) who underwent single-level MIS TLIF or ALIF at L5/S1 were included in the 
      study. Demographic/perioperative variables, presenting patient pathology, and 
      1-year arthrodesis statistics were collected. PROM scores for Visual Analog Scale 
      (VAS) back/leg, Oswestry Disability Index, 12-item Short Form Physical Composite 
      Scale, and Patient-Reported Outcome Measurement Information System Physical 
      Function (PROMIS-PF) were collected from preoperative and postoperative (6 weeks, 
      12 weeks, 6 months, 1 year, 2 years) PROMIS-PF. The obese patients were 
      classified based on the procedure they underwent (MIS TLIF vs. ALIF). RESULTS: 
      The criteria were met by 210 patients in total. After coarsened exact matching 
      for Charlson comorbidity index score, degenerative spondylolisthesis, isthmic 
      spondylolisthesis, degenerative scoliosis, foraminal stenosis, insurance, male, 
      and ethnicity, 94 obese patients were included in the total cohort, with 59 
      receiving MIS TLIF and 35 receiving ALIF. ALIF recipients had higher PROMIS-PF 
      scores at 6 weeks (p=0.014) and 12 weeks (p=0.030), as well as a higher VAS leg 
      at 2 years (p=0.017). Following multiple regression accounting for differences in 
      baseline BMI, only the 6-week PROMIS-PF significantly differed (p=0.028), with no 
      other intergroup differences in mean PROMs between fusion types. Aside from a 
      significantly higher 6-week MCID achievement rate for PROMIS-PF among ALIF 
      recipients (p=0.006), no differences in attainment were observed. CONCLUSIONS: 
      There were no statistically significant differences in perioperative 
      characteristics, fusion rates, PROMs, or MCID achievement between obese patients 
      receiving MIS TLIF vs. ALIF. As a result, our findings indicate that MIS TLIF and 
      ALIF at L5/S1 are equally effective in an obese patient population.
FAU - Patel, Madhav Rajesh
AU  - Patel MR
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Jacob, Kevin Chacko
AU  - Jacob KC
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Zamanian, Cameron
AU  - Zamanian C
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Pawlowski, Hanna
AU  - Pawlowski H
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Prabhu, Michael Clifford
AU  - Prabhu MC
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Vanjani, Nisheka Navin
AU  - Vanjani NN
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Singh, Kern
AU  - Singh K
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20220823
PL  - Korea (South)
TA  - Asian Spine J
JT  - Asian spine journal
JID - 101314177
PMC - PMC10151634
OTO - NOTNLM
OT  - Minimal clinically important difference
OT  - Obesity
OT  - Patient-reported outcome measures
OT  - Spine, Lumbar vertebrae/surgery
COIS- Conflict of Interest No potential conflict of interest relevant to this article 
      was reported.
EDAT- 2022/08/23 06:00
MHDA- 2022/08/23 06:01
PMCR- 2023/04/01
CRDT- 2022/08/22 01:59
PHST- 2022/02/15 00:00 [received]
PHST- 2022/04/24 00:00 [accepted]
PHST- 2022/08/23 06:01 [medline]
PHST- 2022/08/23 06:00 [pubmed]
PHST- 2022/08/22 01:59 [entrez]
PHST- 2023/04/01 00:00 [pmc-release]
AID - asj.2022.0071 [pii]
AID - asj-2022-0071 [pii]
AID - 10.31616/asj.2022.0071 [doi]
PST - ppublish
SO  - Asian Spine J. 2023 Apr;17(2):293-303. doi: 10.31616/asj.2022.0071. Epub 2022 Aug 
      23.