Spinal fusion — ALIF vs. TLIF/PLIF: 5 key findings


A new study published in Spine examines costs, complications, readmissions and discharge disposition for anterior and posterior lumbar interbody fusion patients.


Study authors examined the PearlDriver Database of Medicare records to develop a retrospective review for ALIF and TLIF/PLIF. Study authors found:


1. The odds for ilius infection, wound infection and lower extremity deep vein thrombosis were significantly increased for ALIF patients compared with TLIF/PLIF patients at both 30 and 90 days after surgery.


2. The unadjusted odds of blood transfusion and dural tears were significantly decreased among ALIF patients when compared with TLIF/PLIF patients.


3. At 30 days after surgery, readmission odds were four times higher for ALIF patients than PLIF/TLIF patients.


4. Costs for ALIF patients were $4,800 higher at 30 days after surgery and $5,800 higher at 90 days after surgery when compared with TLIF/PLIF patients.


5. Study authors suggest, "It is necessary to evaluate etiology of degenerative pathology as ALIFs are successful solutions to anterior translational instability and anterior disc slippage, but may not have the best long-term outcomes and may not be cost-effective compared with a TLIF/PLIF."


They suggest surgeons assess the risks and benefits of each approach when deciding how to access the anterior column.


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