[Anterior lumbar interbody fusion as a treatment for chronic refractory lower back pain in disc degeneration and spondylolisthesis using carbon cages - stand alone]. / Die ventrale Spondylodese (ALIF) mit Carbon-Cages - stand alone - zur Behandlung therapieresistenter Kreuzschmerzen bei lumbaler Bandscheibendegeneration und Spondylolisthese.

ABSTRACT

We present a series of 22 patients who were treated between 1997 and 2000 for mono- or bisegmental disc degeneration and spondylolisthesis grade I using Brantigan I/F ALIF cages. A ventral approach was chosen and no dorsal instrumentation was performed. Special emphasis was put on the preoperative evaluation of the individual lower back pain and it's causes. At least 5 (average 17,6) months postoperatively patients were questioned regarding the amelioration of lower back pain. Out of these 18, four reported pain reduction as very good, nine as good, four as satisfactory and one patient as worse. Clinical success after 33,4 months (17-56) was defined according to an expanded Prolo scale. The five-point Likert scales for pain, function, economic status, and medication usage were added to a combined 4-20 point scale. There was an improvement observed from 8,0 points to 12,0 points postoperatively. The ascertained 21 patients were in average on regular pain medication according WHO II before surgery, and WHO I postoperatively. Radiological follow up revealed reconstruction of the preoperatively narrowed disc space and a high rate of fusion. Complications were few and will be outlined in detail. Patient acceptance of the anterior approach was high.