ReviewEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Comparison of anterolateral versus posterior lumbar fusion techniques in obese patients: a systematic review and meta-analysis.
Review 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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
4 authors.
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Abstract
introductionObesity increases the risk of developing lumbar spine disease and the need for subsequent surgical intervention. However, there is no consensus regarding the safety profiles and quality-of-life (QoL) outcomes of different lumbar interbody fusion (LIF) approaches in obese patients. This review compares perioperative, postoperative and QoL outcomes between anterolateral (ALA) and posterior approaches (PA) in obese patients undergoing elective LIF.
methodsPubMed, Scopus, and Cochrane databases were searched for studies comparing ALA and PA in adult obese patients undergoing elective LIF. Pooled risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated for binary and continuous outcomes, respectively. Heterogeneity was assessed using I
resultsEight observational studies comprising 26,030 obese patients undergoing LIF were included, of whom 10,230 (39.30%) underwent an ALA. Risk of bleeding requiring transfusion was significantly lower in the ALA group (8.89% vs. 14.09%; RR = 0.88; 95% CI = 0.81, 0.95; p = 0.002; I
conclusionFor obese patients undergoing elective LIF, ALA reduced the risk of bleeding requiring transfusion and unplanned revision surgery compared to PA. No significant differences in mean VAS-Back or ODI scores were observed at 3 or 6 months. Nevertheless, ALA were associated with higher mean VAS-Back and ODI scores at 12 months. Despite reaching statistical significance, these differences did not attain the minimal clinically important difference (MCID) for either outcome.
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