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Comparison between Anterior Lumbar Interbody Fusion and Posterolateral Fusion in a Punctured Disk Model in Rats

Introduction Conservative treatments are sufficient for patients with discogenic pain; however, fusion surgery is performed to relieve unresolved pain. Of several available fusion techniques, the method remains controversial. This study used pain assessment to compare anterior lumbar interbody fusion (ALIF) versus posterolateral fusion (PLF) in a rat-punctured disk model. Materials and Methods Total 80 male Sprague-Dawley rats (200 to 250 g) were divided into four groups, nonpuncture group(n = 20), puncture group(n = 20), puncture + ALIF group(n = 20), and puncture + PLF group(n = 20). The neurotracer fluoro-gold was applied to detect dorsal root ganglion (DRG) neuron disk innervation. After 1 week of the procedure, surgical treatment was performed in ALIF and PLF groups. After 4 and 8 weeks of surgery, bone union was verified using micro CT, pain behavior was analyzed using CatWalk system, and the proportion of calcitonin gene-related peptide (CGRP) (pain neuropeptide)-immunoreactive, FG-labeled DRG neurons were determined. Results Bone union was confirmed at 4 and 8 weeks in both fusion groups. In CatWalk analysis, ALIF animals significantly improved over 8 weeks compared to PLF animals (p < 0.05). CGRP-immunoreactive DRG neurons increased in all puncture groups compared to nonpuncture group (p < 0.01); however, these decreased in the fusion groups to control levels at 8 weeks, and the significant difference between ALIF and PLF animals was observed only at 2 weeks (p < 0.05). Conclusion After completion of bone union, punctured disk-related pain decreased to control levels in both fusion groups; however, ALIF animals showed faster recovery of pain behavior than PLF animals. These results suggest that both ALIF and PLF are similarly effective for pain originated from degenerated disks, but posterior muscle injury might influence postoperative healing. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest None declared