A new analysis of 917 patients undergoing anterior lumbar interbody fusion (ALIF) for degenerative disc disease found that adding posterior screws may reduce the risk of needing another surgery. The study compared stand-alone ALIF to ALIF combined with posterior pedicle screw fixation.
Overall, about 8% of patients developed pseudarthrosis, meaning the bones did not fuse properly. The rate was slightly higher with stand-alone ALIF (8.95%) compared to combined surgery (6.76%), but this difference was not statistically significant. However, the risk of reoperation for symptomatic pseudarthrosis was significantly higher with stand-alone ALIF: nearly 7 times greater.
Both groups reported similar improvements in pain and function. The study had substantial variation among the included studies, which limits the strength of the conclusions.
For patients considering ALIF, these findings suggest that adding posterior screws may lower the chance of needing a second surgery, even though the overall fusion rates are similar. However, individual risks and benefits should be discussed with a surgeon.