Authors: KyungChul Choi Yong Ahn ByungUk Kang JooHee Jang KyeongKi Kim Yong Hwan Shin JongOh Choi SangHo Lee
Publish Date: 2010/11/17
Volume: 153, Issue: 3, Pages: 567-574
Abstract
The medical records of 223 patients treated with ALIF between January 2007 and June 2008 were retrospectively reviewed Patients with unfavorable outcomes including subsequent posterior decompression at the index level or poor outcomes after ALIF were identified based on clinical and radiological findings The patients were divided into two groups an unfavorable group and a favorable group Preoperative clinical and radiological factors for each group were statistically analyzedTwo hundred of the 223 patients were enrolled in this study Thirteen 65 of 200 patients resulted in unfavorable outcome Four patients 2 of them underwent posterior decompressive surgery The main cause of unfavorable outcomes was incomplete decompression of the foraminal stenosis Unfavorable outcomes were obtained in patients with the level of L5S1 p = 0036 higher body mass index p = 0048 higher percentage of slippage p = 0024 and severe facet arthropathy p = 0013 However there was no difference in preoperative disc height foraminal size facet angle facet tropism or preoperative visual analog scale for back and leg pain the Oswestry disability index symptom duration and fusion rate between the two groupsBased on these results posterior decompression and fusion may be considered for obese patients with the level of L5S1 highgrade spondylolisthesis or severe facet arthropathy On the other hand ALIF can be used an effective alternative treatment in many spinal disorders requiring fusion
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