ALIF in the correction of spinal sagittal misalignment. A systematic review of literature

• Published in: European spine journal 2021, Vol.30 (1), p.50-62
• Main Authors: Formica, M., Quarto, E., Zanirato, A., Mosconi, L., Lontaro-Baracchini, M., Alessio-Mazzola, M., Felli, L.
• Format: Article
• Language: English
• Subjects: Decompression; Intervertebral discs; Leg; Medicine; Medicine & Public Health; Neurosurgery; Review Article; Sacrum; Surgical Orthopedics
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-020-06598-y

Purpose We aim at analysing the impact of anterior lumbar interbody fusion (ALIF) in restoring the main spinopelvic parameters, along with its potentials and limitations in correcting sagittal imbalance. Materials and methods The 2009 PRISMA flow chart was used to systematically review the literature; 27 papers were eventually selected. The following spinopelvic parameters were observed: pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), segmental lumbar lordosis (LLseg) and sagittal vertical axis (SVA). Papers reporting on hyperlordotic cages (HLC) were analysed separately. The indirect decompression potential of ALIF was also assessed. The clinical outcome was obtained by collecting visual analogue scale (VAS) for back and leg pain and Oswestry Disability Index (ODI) scores. Global fusion rate and main complications were collected. Results PT, SS, LL, LLseg and SVA spinopelvic parameters all improved postoperatively by − 4.3 ± 5.2°, 3.9 ± 4.5°, 10.6 ± 12.5°, 6.7 ± 3.5° and 51.1 ± 44.8 mm, respectively. HLC were statistically more effective in restoring LL and LLseg ( p