Anterior lumbar interbody fusion for the management of chronic lower back pain: current strategies and concepts

In a retrospective analysis of two large multicenter clinical studies, 321 patients with degenerative lumbar disc disease were divided into two groups that underwent anterior lumbar interbody fusion using two threaded titanium fusion cages. To determine whether differences in surgical procedures and cage design affect anterior and posterior annular distraction and clinical outcomes, we evaluated the clinical and radiographic outcomes of patients treated with a stand-alone anterior lumbar interbody fusion procedure. End-plate preservation techniques were associated with improved anterior and posterior disc space distraction compared with standard end-plate preparation techniques. The use of the LT-CAGE device led to greater improvements in restoration of segmental lordosis than did the use of standard cylindrical cages. These benefits resulted in improved clinical outcomes as early as 3 months and were maintained over a 2-year follow-up period in patients with improved postoperative disc space distraction and lordosis.