title: Outcomes of anterior lumbar interbody fusion surgery based on indication: a prospective study.
abstract: BACKGROUND
  There is limited information on clinical outcomes after anterior lumbar interbody fusion (ALIF) based on the indications for surgery.
  
  
  OBJECTIVE
  To compare the clinical and radiological outcomes of ALIF for each surgical indication.
  
  
  METHODS
  This prospective clinical study included 125 patients who underwent ALIF over a 2-year period. The patients were evaluated preoperatively and postoperatively. Outcome measures included the Short Form-12, Oswestry Disability Index, Visual Analog Scale, and Patient Satisfaction Index.
  
  
  RESULTS
  After a mean follow-up of 20 months, the clinical condition of the patients was significantly better than their preoperative status across all indications. A total of 108 patients had a Patient Satisfaction Index score of 1 or 2, indicating a successful clinical outcome in 86%. Patients with degenerative disk disease (with and without radiculopathy), spondylolisthesis, and scoliosis had the best clinical response to ALIF, with statistically significant improvement in the Short Form-12, Oswestry Disability Index, and Visual Analog Scale. Failed posterior fusion and adjacent segment disease showed statistically significant improvement in all of these clinical outcome scores, although the mean changes in the Short Form-12 Mental Component Summary, Oswestry Disability Index, and Visual Analog Scale (back pain) were lower. The overall radiological fusion rate was 94.4%. Superior radiological outcomes (fusion >90%) were observed in patients with degenerative disk disease (with and without radiculopathy), spondylolisthesis, and failed posterior fusion, whereas in adjacent segment disease, it was 80%.
  
  
  CONCLUSIONS
  ALIF is an effective treatment for degenerative disk disease (with and without radiculopathy) and spondylolisthesis. Although results were promising for scoliosis, failed posterior fusion, and adjacent segment disease, further studies are necessary to establish the effectiveness of ALIF in these conditions.
authors.affiliation: *Neurospine Clinic, Randwick, Sydney, New South Wales, Australia; ‡Prince of Wales Hospital, Randwick, Sydney, New South Wales, Australia; §University of New South Wales, Sydney, Australia.
authors.forename: Prashanth J
authors.initials: PJ
authors.lastname: Rao
authors.forename: Ajanthan
authors.initials: A
authors.lastname: Loganathan
authors.forename: Vivian
authors.initials: V
authors.lastname: Yeung
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: Mobbs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D018579:Patient Selection; D011446:Prospective Studies; D011843:Radiculopathy / Q000209:etiology / Q000601:surgery; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013168:Spondylolisthesis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome