SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2023
A systematic review of anterior lumbar interbody fusion (ALIF) versus posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), posterolateral lumbar fusion (PLF).
Synthesis in 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, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07217964 (Evaluating Natural Matrix Protein), which is not on this map. Cited by 72 papers, 2 of them syntheses that pooled 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.
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.
Evaluating Natural Matrix Protein (NMP) in Lumbar Spinal Fusion
Who cites it
72 citing papers in PubMed, 2 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- ALIF vs. posterior fusion for lumbar degenerative disease: comparable efficacy but elevated risk of severe complications-a systematic review and meta-analysis.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 · 2025Pooled it
- Morselized corticocancellous bone as primary graft for posterior lumbar fusion: a systematic review and meta-analysis.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 · 2025Pooled it
- Clinical efficacy and quality of life in elderly patients with lumbar degenerative disease treated with TLIF combined with unilateral pedicle screw fixation: a randomized controlled study.Journal of orthopaedic surgery and research · 2025Trial
- Living with pain: Experiences, hopes and expectations when going through lumbar spinal fusion - A qualitative study.International journal of qualitative studies on health and well-being · 2026Article
- Successful execution of preoperative lumbar alignment planning: reliability of the L5-S1 anterior lumbar interbody fusion (ALIF).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 · 2026Article
- Early mechanical outcomes of two expandable interbody cages in minimally invasive TLIF: a comparative single-surgeon study.Journal of spine surgery (Hong Kong) · 2026Article
- Resurgence in BMP Use in Spine Surgery: An Analysis From 2010 to 2022.Global spine journal · 2026Article
- Comparison of anterolateral versus posterior lumbar fusion techniques in obese patients: a systematic review and meta-analysis.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 · 2026Review
- Unilateral uniportal endoscopy with unilateral fixation for lumbar degenerative diseases: A retrospective observational study and technical note.The Journal of international medical research · 2026Observational
- A summer reflection.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 · 2026Article
- Influence of endplate degeneration on fusion process in lateral lumbar interbody fusion.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 · 2026Article
- Article
- Accelerated sagittal remodeling of lumbar facet joints following L4-L5 posterior lumbar interbody fusion: a longitudinal MRI study.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 · 2026Article
- Early pain relief and segmental realignment after two-stage lateral lumbar interbody fusion (LLIF) with posterior instrumentation in degenerative lumbar pathology.Neurosurgical review · 2026Article
- Review
- Paravertebral muscle quality and adjacent facet joint degeneration as significant predictors of ASDis revision after lumbar fusion.Journal of orthopaedic surgery and research · 2026Article
- Risk factors and external validation of nomogram model for patients with postoperative hemoglobin < 80 g/L after lumbar interbody fusion surgery.BMC musculoskeletal disorders · 2026Article
- Clinical and biomechanical outcomes of single-position anterior fixation in anterior lumbar interbody fusion.BMC surgery · 2026Article
- Accuracy and agreement of three blood-loss estimation methods versus the HbMass method for assessing blood loss during PLIF.Journal of orthopaedic surgery and research · 2026Article
- Robotic-assisted midline lumbar interbody fusion for the treatment of degenerative lumbar spinal stenosis: a prospective, randomized, controlled, non-inferiority clinical trial protocol.Journal of spine surgery (Hong Kong) · 2026Article
12 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe rate of elective lumbar fusion has continued to increase over the past two decades. However, there remains to be a consensus on the optimal fusion technique. This study aims to compare stand-alone anterior lumbar interbody fusion (ALIF) with posterior fusion techniques in patients with spondylolisthesis and degenerative disc disease through a systematic review and meta-analysis of the available literature.
methodsA systematic review was performed by searching the Cochrane Register of Trials, MEDLINE, and EMBASE from inception to 2022. In the two-stage screening process, three reviewers independently reviewed titles and abstracts. The full-text reports of the remaining studies were then inspected for eligibility. Conflicts were resolved through consensus discussion. Two reviewers then extracted study data, assessed it for quality, and analysed it.
resultsAfter the initial search and removal of duplicate records, 16,435 studies were screened. Twenty-one eligible studies (3686 patients) were ultimately included, which compared stand-alone ALIF with posterior approaches such as posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), and posterolateral lumbar fusion (PLF). A meta-analysis showed surgical time and blood loss was significantly lower in ALIF than in TLIF/PLIF, but not in those who underwent PLF (p = 0.08). The length of hospital stay was significantly shorter in ALIF than in TLIF, but not in PLIF or PLF. Fusion rates were similar between the ALIF and posterior approaches. The Visual Analogue Scale (VAS) scores for back and leg pain were not significantly different between the ALIF and PLIF/TLIF groups. However, VAS back pain favoured ALIF over PLF at one year (n = 21, MD - 1.00, CI - 1.47, - 0.53), and at two years (2 studies, n = 67, MD - 1.39, CI - 1.67, - 1.11). The VAS leg pain scores (n = 46, MD 0.50, CI 0.12 to 0.88) at two years significantly favoured PLF. The Oswestry Disability Index (ODI) scores at one year were not significantly different between ALIF and the posterior approaches. At two years, ODI scores were also similar between the ALIF and the TLIF/PLIF. However, the ODI scores at two years (2 studies, n = 67, MD - 7.59, CI - 13.33, - 1.85) significantly favoured ALIF over PLF (I
conclusionsStand-alone-ALIF demonstrated a shorter operative time and less blood loss than the PLIF/TLIF approach. Hospitalisation time is reduced with ALIF compared with TLIF. Patient-reported outcome measures were equivocal with PLIF or TLIF. VAS and JOAS, back pain, and ODI scores mainly favoured ALIF over PLF. Adverse events were equivocal between the ALIF and posterior fusion approaches.
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Registered trials
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.