Comparison of Intraoperative and Short-Term Postoperative Outcomes Between Stand-Alone ALIF, 360° ALIF, and Arthroplasty in Patients with Recurrent Lumbar Disc Herniation: A Retrospective Observational Study

Introduction: To compare intraoperative and short-term postoperative outcomes of patients with recurrent lumbar disc herniation undergoing ALIF Stand-Alone, ALIF 360°, or Arthroplasty. Methods: This retrospective cohort study was conducted at a single center from August 2019 to January 2024. Inclusion criteria included patients over 18 years diagnosed with recurrent lumbar disc herniation undergoing ALIF Stand-Alone, ALIF 360°, or Arthroplasty. Exclusion criteria were incomplete data or other indications. Data collected included demographics, surgical specifics (procedure type, operated levels, graft type, incision type), and clinical outcomes (intraoperative morbidity and short-term postoperative outcomes). Results: Sixty-five patients were evaluated. No intraoperative complications occurred in any group. Average operative times were 165.8 ± 61.72 minutes for ALIF Stand-Alone, 236.25 ± 46.3 minutes for ALIF 360°, and 98.43 ± 45 minutes for Arthroplasty (p < 0.0001). The average postoperative hospital stay was 2.46 ± 1.14 days, with no significant difference between groups (p = 0.515). Postoperative complications were minimal: one surgical site infection in the ALIF Stand-Alone group (p = 0.444) and four instances of sympathetic changes (p = 0.477). Conclusion: There was no significant difference in intraoperative morbidity, short-term postoperative outcomes, or length of stay among the three groups. All techniques demonstrated good results with low morbidity and short hospitalization times post-procedure, suggesting that the choice of technique should be based on the surgeon's experience and the patient's condition and preferences.