The Comparison of Changes in the Dimensions of the Intervertebral Disc and Neural Foramen between Anterior Lumbar Interbody Fusion and Posterolateral Fusion in the Lumbar Spine

Abstract

Study Design: A prospective radiologic assessment.

Objectives: To compare the changes of dimensions of the intervertebral disc and neural foramen between the anterior lumbar interbody fusion and the posterolateral fusion in the lumbar spine.

Summary of Literature Review: There are few reports comparing an anterior lumbar interbody fusion with pedicle screw fixation and a posterolateral fusion with pedicle screw fixation.

Materials and Methods: We studied 62 patients with degenerative lumbar diseases who underwent minimal anterior lumbar interbody fusion with pedicle screw fixation (group I, 40 patients) or who underwent posterolateral fusion with pedicle screw fixation (group II, 22 patients). We measured the height of disc and the height, width, and area of the neural foramen measured in 1-mm reconstructive sagittal images of computed tomography before and 6 months after the operation. The factors were independently measured by three different observers.

Results: Disc height was increased by a mean of 39.1±3.28% in group I and 3.1±2.99% in group II. The height of the neural foramen was increased by a mean of 18.7±4.21% in I and 1.0±2.34% in II. The area of neural foramen was increased by a mean of 21.5±3.50% in I and -2.1±4.39% in II, with significant differences between groups in all parameters.

Conclusion: The minimal anterior lumbar interbody fusion with pedicle screw fixation was superior to posterolateral fusion with pedicle screw fixation for increasing disc height and the height and area of neural foramen.