{ "abstract": "Study DesignLiterature review with clinical recommendation.ObjectiveProvide a concise curation of recent literature in interbody fusions at the lumbo-sacral junction.MethodsLiterature is graded based on the integration of scientific methodology and expert opinion.ResultsArticle 1: ALIF with and without posterior instrumentation, Conditional recommendation: ALIF is comparable to 360 fusions in well selected patients. Article 2: ALIF+Perc Screws v. MIS TLIF at L5-S1, Conditional recommendation: use ALIF in cases where higher lordosis correction is needed, Article 3: L4-S1 ALIF v. TLIF with grade 1-2 osteotomy, Conditional recommendation: use ALIF in cases where higher lordosis correction is needed. Article 4: The Deformity TLIF, Conditional recommendation: additional corrective maneuvers (grade 2 osteotomy, rod compression, anterior placement of the cage in the disc, hinged motorized operative table) can aid in achieving lordosis correction. Article 5: Revision rates in isthmic spondylolisthesis, Conditional recommendation: interbody use and 360 fusions decrease revision rates. Article 6: ALIF v. TLIF for isthmic spondylolisthesis, Conditional recommendation: use ALIF+Perc screws when an anterior approach is feasible.ConclusionsSegmental alignment matters, even in short segment constructs. Patients who require large magnitude correction are likely better served with an anterior approach as the literature consistently shows greater lordosis change with ALIF compared to TLIF. Appropriate lordosis is possible with TLIF, but surgeons must implement additional technical steps. For anterior fusions, supplemental fixation reduces the nonunion risk, but may not be necessary in a narrow subset of stable listhesis with good bone quality.", "abstract_shown": true, "affiliations": [ "Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA.", "Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.", "Department of Neurosurgery, Hospital Clínico Regional de Concepción, Concepción, Chile.", "Department of Orthopaedic Surgery, University of California San Francisco, Freemont, CA, USA.", "Department of Neurosurgery, Kasr Alainy Faculty of Medicine, Research and Teaching Hospitals, Cairo University, Cairo, Egypt.", "Neurological & Spinal Surgery Service, Security Forces Hospital, Dammam, Saudi Arabia.", "Department of Orthopaedic Surgery, University of California Davis, Davis, CA, USA.", "Department of Orthopaedic Surgery & Rehabilitation, University of Arkansas for Medical Sciences, North Little Rock, AR, USA.", "Department of Spine Surgery, Orthopaedic Research Group, Coimbatore, Tamil Nadu, India.", "Central Research Laboratory, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission's Research Foundation (Deemed to be University)Puducherry, India.", "Waterloo Regional Health Network, Kitchener, ON, Canada.", "Spine and Pain Center, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.", "Department of Orthopaedics, Emory University, Atlanta, GA, USA.", "Centre for Health Technologies, School of Biomedical Engineering, University of Technology Sydney, Australia.", "SpineLabs, St George and Sutherland Clinical School, The University of New South Wales, Sydney, Australia.", "Spinal Surgery Division of the Department of Traumatology, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia.", "Department of Anatomy, University of Health Sciences, Lahore, Pakistan.", "Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russia.", "Department of Orthopaedic Surgery, St George Hospital Campus, Kogarah, NSW, Australia.", "Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.", "Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA.", "Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.", "Department of Orthopaedics, Division of Spine, University of British Columbia and Vancouver General Hospital, Vancouver, BC, Canada." ], "article_type": "review article", "arxiv": null, "author_total": 22, "authors": [ { "affs": [ 0 ], "name": "Christopher T Martin" }, { "affs": [ 1 ], "name": "Luca Ambrosio", "orcid": "0000-0003-2424-1274" }, { "affs": [ 2 ], "name": "Juan P Cabrera Cousiño", "orcid": "0000-0003-4685-6106" }, { "affs": [ 3 ], "name": "David Gendelberg", "orcid": "0000-0001-8032-4651" }, { "affs": [ 4, 5 ], "name": "Waeel Hamouda", "orcid": "0000-0002-4627-0992" }, { "affs": [ 6 ], "name": "Hai V Le", "orcid": "0000-0002-9111-9060" }, { "affs": [ 7 ], "name": "Mark Feger" }, { "affs": [ 8, 9 ], "name": "Sathish Muthu", "orcid": "0000-0002-7143-4354" }, { "affs": [ 10 ], "name": "Mohamed Sarraj", "orcid": "0000-0002-3879-0445" }, { "affs": [ 11 ], "name": "Rachel Bratescu", "orcid": "0000-0002-2004-0195" }, { "affs": [ 12 ], "name": "S Tim Yoon", "orcid": "0000-0003-1010-6952" }, { "affs": [ 13, 14 ], "name": "Javad Tavakoli" }, { "affs": [ 15 ], "name": "Stipe Corluka", "orcid": "0000-0002-5732-1150" }, { "affs": [ 16 ], "name": "Uruj Zehra", "orcid": "0000-0002-3051-4200" }, { "affs": [ 17 ], "name": "Vadim Byvaltsev", "orcid": "0000-0003-4349-7101" }, { "affs": [ 18 ], "name": "Ashish Diwan" }, { "affs": [ 19 ], "name": "Patrick C Hsieh", "orcid": "0000-0002-7206-4842" }, { "affs": [ 20 ], "name": "Amit Jain", "orcid": "0000-0002-9983-3365" }, { "affs": [ 1 ], "name": "Gianluca Vadalà" }, { "affs": [ 21 ], "name": "Samuel K Cho" }, { "affs": [ 22 ], "name": "Charles G Fischer" }, { "name": "AO Spine Knowledge Forum Degenerative" } ], "bibtex": "https://research.draconitic.com/paper/7117nq7bx8epy.bib", "cited_by": 0, "doi": "10.1177/21925682261492226", "fulltext_url": "https://europepmc.org/articles/PMC13694465", "id": "7117nq7bx8epy", "issns": [ "2192-5682", "2192-5690" ], "landing_url": "https://europepmc.org/article/MED/42925017", "language": "eng", "licence": "CC-BY-NC-ND", "licence_label": "CC BY-NC-ND", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2734|Spine and Intervertebral Disc Pathology" ] ], "openalex": "W7223398587", "pdf_url": "https://europepmc.org/articles/PMC13694465?pdf=render", "pmcid": "PMC13694465", "pmid": "42925017", "published": "2026-10-23", "publisher": null, "ris": "https://research.draconitic.com/paper/7117nq7bx8epy.ris", "sources": [ { "first_seen": "2026-10-30T12:20:33Z", "native_id": "MED:42925017", "source": "europepmc", "url": "https://europepmc.org/article/MED/42925017" } ], "subjects": [ { "field": "medicine", "origin": "journal-openalex:2746|Cervical and Thoracic Myelopathy", "subfield": "surgery" } ], "title": "AO Spine Clinical Practice Recommendations for Interbody Fusion at the Lumbo-Sacral Junction.", "title_text": "AO Spine Clinical Practice Recommendations for Interbody Fusion at the Lumbo-Sacral Junction.", "type": "peer-reviewed", "updated_at": "2026-10-30T12:20:33Z", "url": "https://research.draconitic.com/paper/7117nq7bx8epy", "venue": "Global spine journal", "versions": [] }