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F. Résumé-en,

, Certains auteurs préfèrent réaliser une arthrodèse circonférentielle à cause du risque de faillite mécanique. L'objectif de cette étude de cohorte rétrospective était d'identifier les facteurs de risque de faillite mécanique et de pseudarthrodèse après ALIF L5-S1 isolée et d'évaluer si cette faillite mécanique influençait le taux de fusion. 64 patients (22 hommes (34,4%) et 42 femmes (65,6%)) ayant eu une ALIF L5-S1 isolée on été rétrospectivement inclus. L'âge moyen au moment de la chirurgie était de 46,4 ans (21-65 ans), L'arthrodèse intervertébrale lombaire antérieure (ALIF) L5-S1 isolée est une technique bien établie pour traiter les discopathies dégénératives symptomatiques mais reste controversée pour traiter les spondylolisthésis (SPL) par lyse isthmique

, les paramètres pelviens, l'angle spino-sacré (SSA), le C7 Barrey ratio, la gîte C7, la lordose lombaire L1-S1, la lordose segmentaire, le pourcentage de glissement vertébral, l'angle du disque L5-S1 et le pourcentage de hauteur vertébrale. Les analyses univariée et multivariée ont été réalisées pour identifier les facteurs de risque de faillite mécanique ou de pseudarthrodèse. Après un suivi moyen de 15, Les données cliniques et radiographiques ont été recueillies notamment l'âge, le sexe, l'IMC, vol.6, pp.9-27

, Les paramètres suivants ont influencé la survenue de faillite mécanique : la présence de SPL par lyse isthmique (p<0,001) le haut grade du SPL (p<0,001), l'utilisation d'autogreffe iliaque (p=0,04), la hauteur importante de cage (p=0,03), l'incidence pelvienne (p<0,001), la pente sacrée (p<0,001), le SSA (p=0,003) et la lordose lombaire L1-S1 (p<0,01) élevés. Une faillite mécanique est statistiquement liée à la présence d'une pseudarthrodèse L5-S1 (p<0,001), Une faillite mécanique a été retrouvée chez 12 patients, vol.18

, ces cas, une ALIF associée à une instrumentation postérieure L5-S1 percutanée devrait permettre de diminuer le risque de pseudarthrodèse

, Titre en anglais : Risk factors of instrumentation failure and pseudarthrosis after stand-alone L5-S1 anterior lumbar interbody fusion: a retrospective cohort study

. Résumé,

, The objectives were, to identify risk factors of instrumentation failure and pseudarthrosis after stand-alone L5-S1 anterior lumbar interbody fusion (ALIF) and, to evaluate if instrumentation failure influenced the rate of fusion, L5-S1 stand-alone ALIF is a reliable technique to treat symptomatic degenerative disc disease but remains controversial to treat isthmic spondylolisthesis, p.21

, Univariate and multivariate analysis used to identify risk factors of instrumentation failure and pseudarthrosis. At a mean follow-up of 15.6 months (range 3.9 -27.4 months), 57 patients (89.1%) have fused. Instrumentation failure was found in 12 patients (18.8%) and pseudarthrosis in 7 patients (10.9%). The following parameters influenced the occurrence of instrumentation failure: the presence of an isthmic spondylolisthesis (p<0.001), the grade of the spondylolisthesis (p<0.001), the use of iliac crest bone autograft, to 65 years) using radiolucent anterior cages with vertebridge® plating fixation in each vertebral endplate. Clinical and radiographic data were reviewed, including age, gender, pelvic parameters, the Segmental Sagittal Angle (SSA), C7 Barrey ratio, C7 sagittal tilt, lumbar lordosis (LL), segmental LL, percentage of L5 slippage, the L5-S1 disc angle and the posterior disc height ratio

, Mots clés en français

. Arthrodèse,

, Mots clés en anglais

P. Alif, isthmic spondylolisthesis, instrumentation failure, degenerative disc disease, pelvic incidence, lumbar lordosis, Sacral Slope, Spino-sacral angle