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J Neurol Surg A Cent Eur Neurosurg 2024; 85(04): 349-354
DOI: 10.1055/s-0043-1770357
Original Article

Comparison of ALIF and PLIF in Isthmic Lumbosacral Spondylolisthesis. A Multicenter Surveillance Study of 602 cases from the German Spine Registry (DWG Register)

Lore Marie Bock
1   Department of Traumatology, Sana Klinikum Offenbach, Offenbach, Germany
,
Michael Rauschmann
2   Department of Spine Surgery, Sana Klinikum Offenbach GmbH, Offenbach, Hessen, Germany
,
Vincent Heck
3   Department of Spine Surgery, University Hospital Cologne Clinic and Polyclinic for Orthopaedics and Emergency Surgery, Koln, Nordrhein-Westfalen, Germany
,
Richard Sellei
1   Department of Traumatology, Sana Klinikum Offenbach, Offenbach, Germany
,
Juan Manuel Vinas-Rios
3   Department of Spine Surgery, University Hospital Cologne Clinic and Polyclinic for Orthopaedics and Emergency Surgery, Koln, Nordrhein-Westfalen, Germany
› Author Affiliations Funding None.
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Abstract

Background Isthmic spondylolisthesis most commonly occurs in the lumbosacral junction and can cause backpain and radicular pain as well as stiffness with progressive immobilization, with a negative impact on an individual's ability to work and quality of life. Multiple operative treatments are currently available. This study aims to compare complications, demography, and clinical features between anterior lumbar interbody fusion (ALIF) and posterior lumber body fusion (PLIF) in the operative treatment in isthmic spondylolisthesis.

Methods An analysis of data from the German spine registry (Deutsche Wirbelsäulengesellschaft [DWG]-Register) of patients who underwent operative treatment (PLIF and ALIF) for isthmic spondylolisthesis in the sacrolumbar junction in 170 departments between January 2017 and May 2021 was performed. Age, gender, American Society of Anesthesiologists (ASA) score, surgical approach, smoker/nonsmoker, as well as severeness of the spondylolisthesis according to the Meyerding classification were evaluated.

Results In total, 602 patients undergoing fusion in L5/S1 were identified in the registry, n = 570 PLIF (group 1) and n = 32 ALIF (group 2). A significant difference in the ASA score between the two groups was noted; group 1 had more patients suffering a more debilitating disease in comparison to group 2. There was no significant difference in gender, grade of spondylolisthesis, age, or smoking status. Significant differences were found in operative and postoperative variables and complications (fusion material, dura injury).

Conclusion No difference was found between the two procedures in terms of symptomatic benefit of patients who underwent either ALIF or PLIF. According to the DWG Register, PLIF was the preferred method to treat isthmic spondylolisthesis in the sacrolumbar junction in Germany. To compare these two spine fusion techniques, further studies with an adequate sample size and follow-up period are required.

Keywords

ALIF - PLIF - perioperative complications - spine registry

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


Informed Consent

Informed consent was obtained from all individual participants included in the study.


Availability of Data and Material

The datasets generated and/or analyzed during the current study are available in the DWG Register home page repository: https://dwg.memdoc.org/.


Author Contributions

LMB is the lead author and was responsible for analysis development. MR contributed ideas and was responsible for revision and collection of data. VH and RS also contributed ideas. JMVR is the senior author with final extensive revision and writing of the manuscript. He is the analysis developer and has ownership of the idea. All the authors read and approved the final version of the manuscript.




Publication History

Received: 04 September 2022

Accepted: 07 March 2023

Article published online:
10 July 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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