Anterior lumbar interbody surgery for spondylosis results from a classically-trained neurosurgeon.
Anterior lumbar surgery for degenerative disc disease (DDD) is a relatively novel technique that can prevent damage to posterior osseous, muscular and ligamentous spinal elements. This study reports the outcomes and complications in 286 patients who underwent fusion - with artificial disc implants or combined fusion and artificial disc implants - by a single-operator neurosurgeon, with up to 24 months of follow-up. The visual analogue scale (VAS), Oswestry Disability Index (ODI), Short Form 36 (SF36) and prospective log of adverse events were used to assess the clinical outcome. Radiographic assessments of implant position and bony fusion were analysed. Intraoperative and postoperative complications were also recorded. Irrespective of pre-surgical symptoms (back pain alone or back and leg pain combined), workers' compensation status and type of surgical implant, clinically significant improvements in VAS, ODI and SF36 were primarily observed at 3 and/or 6 month follow-up, and improvements were maintained at 24 months after surgery. A 94% fusion rate was obtained; the overall complication was 9.8% which included 3.5% with vascular complications. The anterior lumbar approach can be used for treating DDD for both back pain and back and leg pain with low complication rates. With appropriate training, single-operator neurosurgeons can safely perform these surgeries.
Neurosurgical Service of Western Australia, 1st Floor, G Block, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia.
Gurkirat
G
Chatha
School of Surgery, The University of Western Australia, Perth, WA, Australia; School of Sport Science, Exercise and Health, The University of Western Australia, Perth, WA, Australia.
Stacy W L
SW
Foo
Neurosurgical Service of Western Australia, 1st Floor, G Block, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia; School of Surgery, The University of Western Australia, Perth, WA, Australia. Electronic address: Christopher.Lind@health.wa.gov.au.
Christopher R P
CR
Lind
Centre for Applied Statistics, School of Mathematics and Statistics, The University of Western Australia, Perth, WA, Australia; Department of Research, Sir Charles Gairdner Hospital, Perth, Australia.
Charley
C
Budgeon
Neurosurgical Service of Western Australia, 1st Floor, G Block, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia.
Paul E
PE
Bannan
D000328:Adult; D001416:Back Pain / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D017586:Diskectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D007866:Leg; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D010147:Pain Measurement; D011859:Radiography; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D055009:Spondylosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D059145:Total Disc Replacement / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
Anterior lumbar interbody fusion; Artificial disc implant; Degenerative disc disease