REVIEW
Esta revisão discute a fusão lombar intersomática por via anterior (ALIF) combinada com gaiola de polieteretercetona (PEEK) para tratar doenças degenerativas da coluna lombar, como degeneração discal, espondilolistese e pseudoartrose, bem como suas possíveis complicações e benefícios. Uma revisão sistemática da literatura para identificar, selecionar e analisar artigos sobre ALIF para tratamento de distúrbios degenerativos ou traumáticos da coluna lombar, publicados de 1988 até março de 2021, foi realizada no banco de dados Public/Publisher MEDLINE. Em nove artigos selecionados, 522 pacientes foram submetidos à ALIF. Entre esses, 17% tiveram complicações intra e extra-operatórias e, devido a elas, 11 (2,1%) necessitaram de reoperação. A média do Índice de Satisfação do Paciente foi de 82,93% em três artigos avaliando 210 pacientes após a cirurgia. A melhora clínico-funcional satisfatória, considerando tempo pós-operatório e recuperação total dos pacientes, baseou-se em Escala Visual Analógica (EVA), Índice de Incapacidade de Oswestry (ODI) e seguimento (média de 18,55 meses). Embora a padronização entre os estudos tenha sido difícil pela utilização de diferentes tipos de materiais e métodos nos artigos pesquisados, a técnica ALIF tem se mostrado um procedimento cirúrgico eficaz. Mais estudos são necessários para padronizar as variáveis para estabelecer efetivamente preditores de resposta de candidatos ao procedimento ALIF.
This review discusses the anterior lumbar interbody fusion (ALIF) procedure combined with a polyetheretherketone (PEEK) cage to treat degenerative diseases of the lumbar spine such as disc degeneration, spondylolisthesis, and pseudarthrosis, as well as their possible complications and benefits. A systematic literature review to identify, select, and analyze articles on ALIF for treating degenerative or traumatic disorders of the lumbar spine, published from 1988 until March 2021, was performed in the Public/Publisher MEDLINE database. In nine articles selected, 522 patients underwent ALIF surgery. Among all the patients surveyed, 17% had intra- and extra-operative complications and due to them, 11 (2.1%) needed reoperation. The mean Patient Satisfaction Index was 82.93% in three articles evaluating 210 patients after the surgery. Satisfactory clinical-functional improvement, considering postoperative time and patients’ total recovery, was based on the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and follow-up (mean of 18.55 months). Although standardization between studies was difficult because different types of material and methods were used in the articles surveyed, the ALIF technique has been proven to be an effective surgical procedure. Further studies are needed to standardize the variables to effectively establish response predictors of candidates for the ALIF procedure.
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1 MD, MSc, Neurosurgeon, Universidade Nove de Julho, São Paulo, SP, Brazil.
2 MD, Hospital Militar de Área de São Paulo, São Paulo, SP, Brazil.
3 Medical student, Universidade Nove de Julho, São Paulo, SP, Brazil.
4 MD, DSc, Universidade Nove de Julho, São Paulo, SP, Brazil.
Received Jun 21, 2023
Corrected Nov 21, 2023
Accepted Nov 28, 2023
