Faculty Collaboration Database

Clinical and radiological relationship between posterior lumbar interbody fusion and posterolateral lumbar fusion. Surg Neurol 2005 Oct;64(4):303-8; discussion 308

Date

09/27/2005

Pubmed ID

16181997

DOI

10.1016/j.surneu.2005.03.025

Scopus ID

2-s2.0-25144472048 (requires institutional sign-in at Scopus site)   36 Citations

Abstract

BACKGROUND: Posterolateral lumbar fusion (PLF) is the most popular technique for stabilizing the lumbar spine. Biomechanically, PLF decreases segmental motion in the posterior column, which presumably reduces facet joint pain. Posterior lumbar interbody fusion (PLIF) may decompress nerve roots by distracting the collapsed disc space, and achieving optimal fusion in relation to load-bearing capacity. The purpose of the study was to examine the role of interbody fixation vs pedicle fixation in transverse lumbar fusion and to assess treated and adjacent disc space height changes over time.

METHODS: One hundred patients who underwent PLIF and noninstrumented transverse process fusion (n = 55) or instrumented PLF (n = 45) between 1996 and 1998 were evaluated retrospectively. Outpatient charts and follow-up films were reviewed. Bone fusion was determined using Brantigan and Steffee's classification and clinical outcome by the Prolo scale. Disc space heights at the fusion and adjacent levels were measured. Analysis of variance and chi(2) statistical techniques were used for data analysis.

RESULTS: Disc space height was increased and better maintained in PLIF patients. PLIF resulted in a nonsignificant tendency toward higher fusion rates. No differences in clinical and functional outcomes were found between the groups. There was no correlation between preservation of disc space height and clinical outcome.

CONCLUSIONS: Disc space height does not seem to impact clinical outcome in lumbar fusion, and efforts to maintain it may be unwarranted.

Author List

Lidar Z, Beaumont A, Lifshutz J, Maiman DJ

Author

Dennis J. Maiman PhD, MD Emeritus Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Arthralgia
Decompression, Surgical
Female
Humans
Internal Fixators
Intervertebral Disc Displacement
Low Back Pain
Lumbar Vertebrae
Male
Middle Aged
Patient Selection
Radiculopathy
Radiography
Retrospective Studies
Spinal Fusion
Spinal Nerve Roots
Treatment Outcome
Zygapophyseal Joint