Original Research
The Effect of Lordosis, Disc Height Change, Subsidence, and Transitional Segment on Stand-Alone Anterior Lumbar Interbody Fusion Using a Nontapered Threaded Device
Am J Orthop. 2010 December;39(12):E124-E129
Author and Disclosure Information
Kevin A. Rahn, MD, Robert M. Shugart, MD, Mark W. Wylie, MD, Kartheek K. Reddy, MD, and Joseph A. Morgan, MD
Dr. Rahn and Dr. Shugart are Spine Surgeons, Fort Wayne Orthopaedics, Fort Wayne, Indiana.
Dr. Wylie is Spine Surgeon, Texas Healthcare Bone and Joint, Fort Worth, Texas.
Dr. Reddy is Resident, Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
Dr. Morgan is Resident Physician, Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri.
In this study, we retrospectively evaluated 37 consecutive patients who underwent stand-alone anterior lumbar interbody fusion (ALIF) for indications that included degenerative disc disease, concordant pain on discography, disc space collapse of more than 50%, and failure of nonoperative management for at least 4 consecutive months.
Patient demographics, procedural data, and prospective Short Form 36 General Health Survey composite scores were collected. Mean follow-up was 24.2 months.
In this cohort of patients with degenerative disc disease, there was no loosening or migration of implants. Stand-alone ALIF using a threaded interbody fusion device provided excellent clinical results and return-to-work rates with few complications. Increased lordosis was associated with increased subsidence and less favorable outcome. Patients with a transitional segment displayed relatively smaller increases in lordosis and better outcomes than patients without a transitional segment.