AO Spine Clinical Practice Recommendations for Interbody Fusion at the Lumbo-Sacral Junction
Christopher T. Martin, Luca Ambrosio, Juan P. Cabrera Cousiño, David Gendelberg, Waeel Hamouda, Hai V. Le, Mark Feger, Sathish Muthu, Mohamed Sarraj, Rachel Bratescu, S. Tim Yoon, Javad Tavakoli, Stipe Corluka, Uruj Zehra, Vadim Byvaltsev, Ashish Diwan, Patrick C. Hsieh, Amit Jain, Gianluca Vadalà, Samuel K. Cho, Charles G. Fischer,Study Design
Literature review with clinical recommendation.
Objective
Provide a concise curation of recent literature in interbody fusions at the lumbo-sacral junction.
Methods
Literature is graded based on the integration of scientific methodology and expert opinion.
Results
Article 1:
Conclusions
Segmental alignment matters, even in short segment constructs. Patients who require large magnitude correction are likely better served with an anterior approach as the literature consistently shows greater lordosis change with ALIF compared to TLIF. Appropriate lordosis is possible with TLIF, but surgeons must implement additional technical steps. For anterior fusions, supplemental fixation reduces the nonunion risk, but may not be necessary in a narrow subset of stable listhesis with good bone quality.