Evidence map›Paper›PMID 40571487›Full record

ArticleInternational journal of spine surgery2025

Does Anterior Lumbar Interbody Fusion Reduce Mechanical Complication and Pseudarthrosis Rate at the Lumbosacral Junction in Adult Spinal Deformity Surgery in Comparison to Posterior Lumbar Interbody Fusion?

Mohamed Kamal A Mohamed, Michael Rauschmann, Andrei Slavici, Marcus Rickert, Sebastian Walter, Nikolaus Kernich, Krishnan Sircar, Peer Eysel, Vincent J Heck

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of spine surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
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

9 authors.

Mohamed Kamal A MohamedGoethe University School of Medicine and University Hospital Frankfurt am Main, Department of Orthopaedic Surgery, Goethe University Frankfurt, Frankfurt am Main, Germany mkamal1@web.de.ORCID http://orcid.org/0009-0003-3680-8407
Michael RauschmannCentre for Complex Spine Service and Reconstructive Orthopaedic Surgery, Sana Academic Teaching Hospital, Offenbach am Main, Germany.
Andrei SlaviciCentre for Complex Spine Service and Reconstructive Orthopaedic Surgery, Sana Academic Teaching Hospital, Offenbach am Main, Germany.
Marcus RickertOrthopaedic Private Practice, Rickert Orthopaedic Centre, Seligenstadt, Germany.
Sebastian WalterCologne University School of Medicine and University Hospital Cologne, Department of Orthopaedic, Trauma and Plastic Surgery, University of Cologne, Cologne, Germany.
Nikolaus KernichCologne University School of Medicine and University Hospital Cologne, Department of Orthopaedic, Trauma and Plastic Surgery, University of Cologne, Cologne, Germany.
Krishnan SircarCologne University School of Medicine and University Hospital Cologne, Department of Orthopaedic, Trauma and Plastic Surgery, University of Cologne, Cologne, Germany.
Peer EyselCologne University School of Medicine and University Hospital Cologne, Department of Orthopaedic, Trauma and Plastic Surgery, University of Cologne, Cologne, Germany.
Vincent J HeckCologne University School of Medicine and University Hospital Cologne, Department of Orthopaedic, Trauma and Plastic Surgery, University of Cologne, Cologne, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo evaluate the impact of anterior lumbar interbody fusion (ALIF) vs posterior lumbar interbody fusion (PLIF) at the lumbosacral junction on mechanical complications and fusion rate at the caudal lumbar segments in adult spinal deformity (ASD) surgery.

methodsThis retrospective cohort study included ASD patients with coronal or sagittal imbalance who underwent thoracolumbar to pelvic fusion with ALIF or PLIF technique at the lumbosacral junction and a minimum follow-up of 2 years. The primary focus was on mechanical complications, including material failure and sacral fracture, implant-related pain, pseudarthrosis, and reoperation. Patient-specific and perioperative characteristics were also analyzed at the 2-year follow-up. The primary focus was on mechanical complications, including material failure and sacral fracture, implant-related pain, pseudarthrosis, and reoperation. Patient-specific and perioperative characteristics were also analyzed.

resultsA total of 56 patients were included, comprising 32 ALIF and 24 PLIF patients, with a mean age of 79.5 ± 6.6 years. The overall mechanical complication rate was 19.6%, including screw loosening (7.1%), rod breakage (5.4%), sacral fracture (3.6%), and screw breakage (1.8%). Pseudarthrosis and reoperation rates were 10.7% each. ALIF significantly reduced mechanical complications compared with PLIF (9.4% vs 37.5%,

conclusionApproximately 1 in 5 patients experiences mechanical complications within 2 years of ASD correction surgery. ALIF at the lumbosacral junction significantly reduces mechanical complications and pseudarthrosis compared with PLIF, resulting in lower reoperation rates. These findings suggest that ALIF should be the preferred technique for lumbosacral fusion in long-segment ASD constructs, provided there is no spondylolisthesis or severe spinal stenosis with L5 nerve root compression requiring simultaneous direct posterior decompression and fusion. This is particularly important in patients at risk for mechanical complications and pseudarthrosis, including those undergoing revision procedures. LEVEL OF EVIDENCE: 3 - Retrospective comparative study.

Indexed as

adult spinal deformityAnterior Lumbar Interbody Fusion (ALIF)degenerative lumbar scoliosisLong-Segment FusionLumbar Spine SurgeryLumbosacral junctionmechanical complicationsposterior lumbar interbody fusion (PLIF)Post-operative outcomepseudarthrosisSpinal FusionSurgical Outcome

Identifiers

PMID40571487
PMCPMC12571043

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.