PMID- 37443066 OWN - NLM STAT- MEDLINE DCOM- 20230717 LR - 20230718 IS - 1749-799X (Electronic) IS - 1749-799X (Linking) VI - 18 IP - 1 DP - 2023 Jul 13 TI - Surgical outcomes of anterior lumbar interbody fusion in revision lumbar interbody fusion surgery. PG - 497 LID - 10.1186/s13018-023-03972-6 [doi] LID - 497 AB - BACKGROUNDS: Anterior lumbar interbody fusion (ALIF) is an attractive option for revision lumbar interbody fusion as it provides wide access for implant removal and accommodation of large interbody grafts for fusion. However, revision lumbar interbody fusion surgery has not been found to result in significantly better functional outcomes compared with other approaches. To date, no prognostic factors of anterior lumbar interbody fusion in revision lumbar interbody fusion have been reported. In this study, we investigated the surgical results and possible prognostic factors of anterior lumbar interbody fusion in revision lumbar interbody fusion. METHODS: Patients who received revision interbody fusion surgery between January 2010 and May 2018 in our hospital were reviewed. Clinical outcomes were determined according to whether the VAS score improvement in back pain and leg pain reached the minimum clinically important difference (MCID) and Macnab criteria. Radiographic outcomes were assessed with fusion rate, preoperative, and postoperative lumbar lordosis. Operative-relative factors that may affect clinical outcomes, such as BMI, existence of cage migration, cage subsidence, pseudarthrosis, previous procedure, and number of fusion segments, were collected and analyzed. RESULTS: A total of 22 consecutive patients who received ALIF for revision interbody fusion surgery were included and analyzed. There were 9 men and 13 women with a mean age at operation of 56 years (26-78). The mean follow-up was 73 months (20-121). The minimal clinically important difference (MCID) was reached in 11 (50%) of the patients for back pain and 14 (64%) for leg pain. According to the modified Macnab criteria, 73% of the patients in this study had successful outcomes (excellent or good). The pain and lumbar lordosis had significant improvement (P < 0.05). Preoperative fusion segment >/= 2 was shown to be a poor prognostic factor for back pain improvement reaching MCID (P = 0.043). CONCLUSIONS: ALIF has proven effective for revision lumbar fusion surgery, yielding positive clinical and radiographic results. However, having two or more preoperative fusion segments can negatively impact back pain improvement. LEVEL OF EVIDENCE: IV. CI - (c) 2023. The Author(s). FAU - Shih, Cheng-Min AU - Shih CM AD - Department of Orthopaedic Surgery, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan. AD - College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan. AD - Department of Physical Therapy, Hungkuang University, Taichung, Taiwan. FAU - Hsu, Cheng-En AU - Hsu CE AD - Department of Orthopaedic Surgery, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan. jacobhe2001@gmail.com. AD - Sports Recreation and Health Management Continuing Studies-Bachelor's Degree Completion Program, Tunghai University, Taichung, Taiwan. jacobhe2001@gmail.com. FAU - Chen, Kun-Hui AU - Chen KH AD - Department of Orthopaedic Surgery, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan. AD - Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan. AD - College of Computing and Informatics, Providence University, Taichung, Taiwan. FAU - Pan, Chien-Chou AU - Pan CC AD - Department of Orthopaedic Surgery, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan. AD - Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan. AD - Department of Rehabilitation Science, Jenteh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan. FAU - Lee, Cheng-Hung AU - Lee CH AD - Department of Orthopaedic Surgery, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan. AD - Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan. AD - Department of Food Science and Technology, Hungkuang University, Taichung, Taiwan. LA - eng PT - Journal Article DEP - 20230713 PL - England TA - J Orthop Surg Res JT - Journal of orthopaedic surgery and research JID - 101265112 SB - IM MH - Male MH - Humans MH - Female MH - Adult MH - Middle Aged MH - Aged MH - *Lordosis/surgery MH - Treatment Outcome MH - Retrospective Studies MH - Lumbosacral Region/surgery MH - Back Pain MH - Lumbar Vertebrae/diagnostic imaging/surgery MH - *Spinal Fusion/methods PMC - PMC10339485 OTO - NOTNLM OT - Anterior lumbar interbody fusion OT - Lumbar fusion OT - Nonunion OT - Revision lumbar interbody fusion OT - Revision spine surgery COIS- The authors declare that they have no competing interests. EDAT- 2023/07/14 13:06 MHDA- 2023/07/17 06:42 PMCR- 2023/07/13 CRDT- 2023/07/13 23:31 PHST- 2023/03/16 00:00 [received] PHST- 2023/07/03 00:00 [accepted] PHST- 2023/07/17 06:42 [medline] PHST- 2023/07/14 13:06 [pubmed] PHST- 2023/07/13 23:31 [entrez] PHST- 2023/07/13 00:00 [pmc-release] AID - 10.1186/s13018-023-03972-6 [pii] AID - 3972 [pii] AID - 10.1186/s13018-023-03972-6 [doi] PST - epublish SO - J Orthop Surg Res. 2023 Jul 13;18(1):497. doi: 10.1186/s13018-023-03972-6.