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Purpose <p>This study evaluated the radiological and functional outcomes of anterior lumbar reconstruction for collapsed discs following recurrent disc prolapse (RDP) using stand-alone anterior lumbar interbody fusion (ALIF). We assessed functional outcomes, fusion success, and changes in disc height and lumbar lordosis.</p> Methods <p>A retrospective review was conducted on prospectively collected data from 71 patients. Patient-reported outcome measures (PROMs), including VAS for back and leg pain, ODI, and EQ-5D-5&#xa0;L, were recorded preoperatively and postoperatively. Fusion was assessed using thin-slice CT scans and dynamic flexion-extension radiographs. Disc height, segmental lordosis, and total lumbar lordosis were measured before and after surgery.</p> Results <p>The mean follow-up period was 36.8 months. The average surgical time was 72&#xa0;min per level (range: 55–110). Preoperative disc height averaged 5.8&#xa0;mm (range: 3–10) and increased to 13.1&#xa0;mm (range: 9–17) postoperatively (<i>p</i> &lt; 0.001). Significant improvements were observed in segmental and total lordosis. The CT-confirmed fusion rate was 98.6%. PROMs showed statistically significant improvements at all postoperative follow-ups. The number of prior discectomies did not impact outcomes. However, the presence of epineural fibrosis had a statistically significant negative effect on VAS leg pain improvement.</p> Conclusion <p>ALIF is an effective surgical option for managing RDP, particularly in cases with significant disc height and lordosis loss. This study, which represents the largest single-surgeon series to date, demonstrates excellent functional and radiological outcomes with a low complication rate.</p>

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Anterior lumbar spine reconstruction and fusion to restore lordosis and disc height for the treatment of recurrent lumbar disc prolapse. Functional and radiological outcomes

  • 期刊论文

  • 发表日期：

    2026年7月27日

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  • Ata Kasis,
  • Cyrus Jensen,
  • Yousef Al-khatib,
  • Anji Kingman,
  • Ramakrishna Bethanabatla,
  • Matthew Mawdsley

摘要

Purpose

This study evaluated the radiological and functional outcomes of anterior lumbar reconstruction for collapsed discs following recurrent disc prolapse (RDP) using stand-alone anterior lumbar interbody fusion (ALIF). We assessed functional outcomes, fusion success, and changes in disc height and lumbar lordosis.

Methods

A retrospective review was conducted on prospectively collected data from 71 patients. Patient-reported outcome measures (PROMs), including VAS for back and leg pain, ODI, and EQ-5D-5 L, were recorded preoperatively and postoperatively. Fusion was assessed using thin-slice CT scans and dynamic flexion-extension radiographs. Disc height, segmental lordosis, and total lumbar lordosis were measured before and after surgery.

Results

The mean follow-up period was 36.8 months. The average surgical time was 72 min per level (range: 55–110). Preoperative disc height averaged 5.8 mm (range: 3–10) and increased to 13.1 mm (range: 9–17) postoperatively (p < 0.001). Significant improvements were observed in segmental and total lordosis. The CT-confirmed fusion rate was 98.6%. PROMs showed statistically significant improvements at all postoperative follow-ups. The number of prior discectomies did not impact outcomes. However, the presence of epineural fibrosis had a statistically significant negative effect on VAS leg pain improvement.

Conclusion

ALIF is an effective surgical option for managing RDP, particularly in cases with significant disc height and lordosis loss. This study, which represents the largest single-surgeon series to date, demonstrates excellent functional and radiological outcomes with a low complication rate.