Analysis of pain intensity and quality of life in patients with lumbar disc disease treated with PLIF (Posterior Lumbar Interbody Fusion) and ALIF (Anterior Lumbar Interbody Fusion) interbody stabilization methods: a 3-month retrospective analysis
Kazimiera Hebel, Sylwia Jałtuszewska, Monika Dydyna, Katarzyna Kubała, Aleksandra BryndalBackground
Lumbar disc disease is one of the most common causes of spinal pain and represents a significant health problem. Surgical treatment often involves interbody stabilization, performed using Posterior Lumbar Interbody Fusion (PLIF) or Anterior Lumbar Interbody Fusion (ALIF) methods.
Methods
A retrospective cohort study was conducted on 112 patients (64 women, 48 men) with lumbar disc disease aged 17–72 years. Patients underwent PLIF (73 patients, 65.18%) or ALIF (39 patients, 34.82%) procedures. Pain assessment utilized the visual analogue scale (VAS) scale and numerical rating scale (NRS) for specific disc disease symptoms. Quality of life was measured using Cantril’s ladder retrospectively before symptom onset, 3 months post-operation, and prospectively for predicted future (2–3 years). Robust linear regression models with interaction analysis were applied.
Results
Significant pain reduction on the VAS scale was found after 3 months (average 6.07 points, p < 0.001). Both procedures demonstrated significant pain reduction at 3 months. Pain outcomes varied by symptom type, with substantial improvements observed in overall pain, spinal pain, limb pain, and numbness across both surgical approaches. Most symptoms showed very high effect sizes (r ≥ 0.97), except for spinal stiffness. Quality of life significantly improved over time ( p < 0.001), with higher baseline values after ALIF (0.66 points, p = 0.001). Physical activity improved quality of life, while tobacco smoking increased spinal stiffness.
Conclusions
Both PLIF and ALIF demonstrated substantial reductions in pain complaints and improvements in quality of life in patients with lumbar disc disease in 3-month follow-up. Both PLIF and ALIF demonstrated substantial pain reduction and quality of life improvement in 3-month follow-up. However, definitive recommendations for method selection require long-term studies with patient randomization and longer follow-up periods.