Evidence map›Paper›PMID 32042993›Full record

ArticleJournal of spine surgery (Hong Kong)2019

Anterior lumbar interbody fusion in a lateral decubitus position: technique and outcomes in obese patients.

Gregory M Malham, Timothy P Wagner, Matthew H Claydon

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of spine surgery (Hong Kong), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
3.2field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.

  1. Obesity and anterior lumbar interbody fusion: a bayesian meta-analysis of complications and outcomes.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
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  13. Single-position circumferential lumbar spinal fusion: an overview of terminology, concepts, rationale and the current evidence base.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022
    Review
  14. Anterior column reconstruction of the lumbar spine in the lateral decubitus position: anatomical and patient-related considerations for ALIF, anterior-to-psoas, and transpsoas LLIF approaches.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022
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  16. Single-Position Anterior Column Lateral Lumbar Interbody Fusion.International journal of spine surgery · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Gregory M MalhamEpworth Hospital, Melbourne, Australia.
Timothy P WagnerEpworth Hospital, Melbourne, Australia.
Matthew H ClaydonEpworth Hospital, Melbourne, Australia.
Epworth Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMultilevel lumbar interbody fusion (LIF) surgery in obese patients is problematic, with positioning and anaesthetic risks during posterior approaches, vascular and visceral complications during anterior approaches, and lack of access to L5/S1 during lateral approaches. Modified anterior LIF (ALIF) via an anterolateral retroperitoneal approach in the lateral decubitus position permits access to L3/4, L4/5, and L5/S1 levels without patient repositioning. This study reports our initial experience with this lateral ALIF in obese patients and describes modifications of existing lateral and anterior techniques.

methodsWe retrospectively analysed a prospectively maintained registry including the first 30 consecutive patients who underwent lateral ALIF. In all patients, supine ALIF was relatively contraindicated because of obesity or previous abdominal surgery. All patients had a body mass index (BMI) ≥30 kg/m

resultsAt last follow-up (mean, 35.0 months) mean back pain improved 64%, leg pain improved 67%, ODI improved 54%, and PCS and MCS both improved 37% (P<0.05 versus preoperative for all). Mean BMI was unchanged postoperatively (P=0.83). Complications occurred in 7 (23%) patients: dysesthesia [2], retroperitoneal hematoma [2], radiculopathy [1], and subsidence [2]. Solid interbody fusion occurred in 19 (63%) patients at 12 months postoperatively and in 26 (87%) patients at 24 months.

conclusionsLateral ALIF enables L5/S1 anterior fusion in obese patients and permits multilevel fusion using a single position. Satisfactory clinical outcomes and complication rates are achieved despite unchanged BMI and 87% radiological fusion rates. Lateral ALIF appears to be a reasonable alternative to posterior, lateral, and supine-position anterior approaches for L3/4, L4/5, and L5/S1 interbody fusions.

Indexed as

Anteriorinterbody fusionlateralobesetechnique

Identifiers

PMID32042993
PMCPMC6989931
OpenAlexW2979924260

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.