| Long term Results of Mini-open Anterior Lumbar Interbody Fusion(ALIF) (minimum 3years follow-up) |
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Byong-Gil Son, M.D., Eun-Seok Choi, M.D., Jong-Hyun Shin, M.D., Myung-Jin Kim, M.D., Eul-Soo Jung, M.D., Kwang-Ju Bae, M.D., Yong-Chul Chi, M.D. |
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Department of Neurosurgery, Bogang Hospital, Daegu, Korea |
| 최소 개복 전방 요추체간 유합술의 장기분석 결과 |
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손병길,최은석,신종현,김명진,정을수,배광주,지용철 |
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보강병원 신경외과 |
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| Abstract |
Objective: To determine the long term clinical and radiological results of mini-open anterior lumbar interbody fusion(ALIF)
Methods: 93 patients underwent mini-open ALIF between September 1999 and February 2002. The subjects were 61 men and 32 women, with a mean age of 40.6 years, ranging from 19 to 71 at the time of ALIF. The preoperative diagnoses were recurred herniated lumbar disc(HLD) in 49 patients, central HLD in 22 patients, degenerative disc disease(DDD) in 18 patients, foraminal stenosis in 2 patients, and far lateral stenosis in 2 patients. Two kind of cages were used with allograft in our serise [Carbone cage, PEEK cage]. Patients were followed clinically and radiologically for more than 3years(average 4.3 years). The surgical result was analyzed using Japanese Orthopedic Association(JOA) system and Bogang Score Rating System(BSRS) according to medication, activity of daily living(ADL) and degree of improvement and satisfaction. The preoperative and postoperative intervertebral disc height, intervertebral graft union were evaluated by serial radiographs.
Results: The mean preoperative JOA score was 8.15±2.005. At 1year, 2years after surgery and at the final follow up examination, the mean JOA scores were 12.3±1.435, 12.56±1.463, 12.84±2.183 respectively(p<0.05). 69 of 93 patients (74%) were satisfied with their clinical results. Overall fusion rate was 90%(complete fusion 66%, probably fusion 24%). There was a statistical difference between fusion and non-fusion groups in BSRS(P<0.05). 74 of 93 patients(79.5%) developed subsidence. A total of 10 complications(11%) were noted [deep vein thrombosis(1), dura tear(1), nerve root damage(1), anhydrosis(4), numbness & dysesthesia(2), superficial wond infection(1)]. During the follow up, 4 cases of adjacent level HLD, 1 case of adjacent level instability were developed.
Conclusion: Mini-open ALIF provides safe and relatively satisfactory overall long term clinical results in selected patients. |
| Keywords:
Mini-open anterior lumbar interbody fusion.Subsidence.Complications |
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