L5-S1 laparoscopic anterior interbody fusion.
OBJECTIVE
We evaluated our experience with laparoscopic L5-S1 anterior lumbar interbody fusion (ALIF).


METHODS
This represents a retrospective analysis of consecutive patients who underwent L5-S1 laparoscopic ALIF between February 1998 and August 2003.


RESULTS
Twenty-eight patients underwent L5-S1 LAIF (15 males and 13 females). The mean age was 43 years (range, 26 to 67). Mean operative time was 225 minutes (range, 137 to 309 minutes). No conversions to an open procedure were necessary. Twenty-four (85.7%) patients underwent successful bilateral cage placement. Four patients (14.3%) in whom only a single cage could be placed underwent supplementary posterior pedicle screw placement. Mean length of stay (LOS) was 4.1 days (range, 2-to 15). Two patients underwent reoperation subacutely secondary to symptomatic lateral displacement of the cage. One patient developed radiculopathy 6 months postoperatively and required reoperation. One patient developed a small bowel obstruction secondary to adhesions to the cage requiring laparoscopic reoperation. Fusion was achieved in all patients. Visual analogue scale scores for back pain were significantly improved from 8.6+/-0.8 to 2.8+/-0.8 (P<0.0001) at 1 year.


CONCLUSIONS
L5-S1 LAIF is feasible and safe with all the advantages of minimally invasive surgery. Fusion rates and pain improvement were comparable to those with an open repair.
Frantzides
Constantine T
CT
Minimally Invasive Surgery Center, Department of Surgery, Evanston Northwestern Healthcare and Northwestern University, Evanston, Illinois 60201, USA. cfrantzides@enh.org
Zeni
Tallal M
TM
Phillips
Frank M
FM
Mathur
Sameer
S
Zografakis
John G
JG
Moore
Ronald M
RM
Laguna
Luis E
LE
D000328:Adult; D000368:Aged; D001416:Back Pain / Q000209:etiology / Q000601:surgery*; D001863:Bone Screws; D001864:Bone Wires; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications; D012189:Retrospective Studies; D012447:Sacrum / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome