A Retrospective Study of the Fusion Rate and Clinical Outcome after Mini-open ALIF using Paired Stand-alone Rectangular Cages.

Choi, Jae Young; Jeong, Hyun Tae; Hyun, Yong In; Sung, Youn Sang; Lee, Wan Su; Sung, Kyeong Hoon

Original Article

Journal of Korean Neurosurgical Society 2004;36(1): 28-33.

Jae Young Choi, Hyun Tae Jeong, Yong In Hyun, Youn Sang Sung, Wan Su Lee, Kyeong Hoon Sung

Department of Neurosurgery, 21st Century Hospital, Seoul, Korea. madi121@yahoo.com

ABSTRACT

OBJECTIVE
We conduct a study to determine the fusion rate and clinical outcome after mini-open anterior lumbar interbody fusion(ALIF) in selected patients with a degenerative lumbar disc disease. METHODS: Ninety-four patients underwent the ALIF procedure between November 2000 and June 2002. The subjects were 23 men and 71 women, with a mean age of 52 years(range, 25-72). The mean follow-up duration was 21 months(range, 13-32). Clinical outcome was assessed using the modified Japanese Orthopedic Association(JOA) low back pain score and the 10-point visual analogue scale(VAS). Radiologic evaluation was performed using plain radiographs. The intervertebral disc height was measured and expressed as the percentage of the total disc height to the AP diameter of the vertebral body.
RESULTS
The overall fusion rate in our series was 88.3%. The mean preoperative JOA score was 8.3+/-1.6. At the last follow up visit, the mean JOA score was increased to 13.1+/-1.1, respectively(p<0.001). VAS showed a similar result to JOA score(p<0.001). The preoperative intervertebral disc height was 36.7+/-9.9%. Postoperatively, the disc height spread to 53.3+/-10.8% one month after surgery, but diminished to 46.6+/-11.9% at the last follow-up.
CONCLUSION
Our study shows that ALIF using stand-alone rectangular cages remains effective for the indicated conditions in patients with a degenerative lumbar disc disease.

Key Words: Anterior lumbar interbody fusion; Degenerative disc disease; Low back pain