This is a recent study of anterior interbody fusion outcomes at the University of Miami.

1. Michael Thomas D.O.
University of Miami
Spine Fellow

3. -SINCE 1960 –MULTIPLE ALIF MODIFICATIONS
-HISTORY OF CONTROVERSY OF STAND ALONE IMPLANTS
-GROWING RECENT TRENDS TOWARD STAND ALONE
ALIF EARLY EXPERIENCE AND OUT
COMES OF STAND ALONE ALIF
DEVICES
STEVEN VANNI D.O.
SR. AUTHOR AND NEUROSURGEON
OUR

4. DR CLOWARD FIRST PERFORMED ALIF SURGERY IN 1950s
FOR LOW BACK PAIN AND DDD
WAS NOT WIDELY ACCEPTED BECAUSE OF 30-40% NON
UNION RATES
IN THE 1990s THERE WAS A RESURGENCE OF
ALIF’s BECAUSE OF THE ADVENT OF NEW THREADED
TITANIUM CAGES THAT HELD THE DISK SPACE BETTER
AND ALLOWED FOR HIGHER FUSION RATES
(RAY THREADED CAGE, BAKER THREADED CAGE AND
CARBON FIBER CAGES)
CURRENTLY FUSION RATES ARE AS HIGH AS 95% WITH
THE NEW ALIF TECHNOLOGY

5. THE ALIF DEVICE IS DESIGNED AND UTILIZED
FOR ANTERIOR FIXATION AND FDA
APPROVED FOR 1 AND 2 LEVEL CONTIGUOUS
FUSIONS

10. RETROSPECTIVE CASE REVIEW OF 22 PATIENTS
ALL PATIENTS HAD ALIF PEEK CAGES W/ LOW PROFILE PLATE
AND CORTICAL SCREWS
REVIEWED CHARTS FOR NUMBER OF LEVELS
REVIEWED SUBSTRATE USED IN THE INTERBODY DEVICE
CATEGORIZED THE BODY MAS INDEX OF EACH PATIENT
FUSION WAS ACESSED BY THE PRIMARY SURGEON AND AN
INDEPENDENT RADIOLOGIST
FUSION CRITERIA INCLUDED TRABECULAR BONE FORMATION ON
XRAY’s/CT SCAN’s OF THE LUMBAR SPINE
THE PTS SMOKING STATUS WAS NOT CONSIDERED IN THIS STUDY

13.  10 ALIF LEVELS WERE SUPPLEMEMTED WITH PEDICLE SCREWS (SOME OF
THESE PROCEDURES WERE PART OF LONG CONSTRUCTS FOR
DEFORMMITY CORRECTION)
 MULTIPLE LEVEL ALIF’s W/ PEDICLE SCREWS =2 PATIENTS/4 LEVELS
 MULTIPLE LEVEL STAND ALONE ALIF FUSIONS = 3 PTS/6 LEVELS
 SINGLE LEVEL STAND ALONE ALIF’s =11
 TOTAL STAND ALONE ALIF’S=17 LEVELS -
 THE NON-UNION LEVEL ALREADY HAD PEDICLE SCREWS (REVISION
CASE)
 FUSION RATE WAS 96.3 %

14. 70 YEAR OLD FEMALE W/ 2 YEAR HX
OF
SEVERE BACK AND BILATERAL LEG
PAIN
PREVIOUS L3-4 LAMINECTOMY AND
FUSION
EXAM
LIMITED ROM W/ FLEXION AND
EXTENSION
ANTALGIC GAIT WITH DIFFICULTY
HEEL AND TOE WALKING
NEURO EXAM OTHERWISE NEGATIVE

17. 60 YEAR OLD FEMALE
WITH RECENT HX OF MVA
C/O BACK PAIN 10/10
AND BILATERAL LEG PAIN
9/10
FAILED CONSERVATIVE
MANAGEMENT
EXAM
ANTALGIC GAIT AND
BILATERAL STRAIGHT LEG
RAISING TEST
NEUROLOGICAL EXAM
UNREMARKABLE

20. IT IS OUR EARLY EXPERIENCE THAT STAND ALONE ALIF
TECHNOLOGY WITH THE USE OF BMP IS A FEASIBLE
OPTION COMPARED TO TLIF AND PLIF PROCEDURES.
THE FUSIONS WERE QUITE ROBUST WITH MINIMAL
SUSIDENCE OF THE INTERBODY DEVICES.
THE DURATION OF SURGERY AND BLOOD LOSS
WAS CALCULATED TO BE MINIMAL
COMPARED TO THE POSTERIOR APPROCHES
MAINTAINANCE OF LORDOSIS AND SAGITAL
BALANCE IS TO PLIF OR TLIF
THE ONLY DEMERIT WAS AQUIRING AN ACCESS
SURGEON