Study of Functional Outcome of Posterior Lumbar Interbody Fusion Technique with Implant in Degenerative Spondylolisthesis at L4 and L5 Level
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Abstract
Background: Lumbar interbody fusion is the most reliable fusion technique currently available for the lumbar spine as these constructs are biomechanically stronger, provide axial support with less graft subsidence or collapse comparing to those with posterolateral arthrodesis, and produce a better biologic fusion in lordotic alignment1, 2. Aims and Objectives: To study functional outcome of posterior lumbar interbody fusion technique with implant in degenerative spondylolisthesis at L4 and L5 level. Materials and Methods: The study was carried on 34 patients enlisting in the casualty or inpatient department of orthopaedics at a medical college and tertiary health care centre. Only those patients satisfying the inclusion and exclusion criteria were included in the study. All the patients were explained about the surgical procedure, the purpose of the study and Informed consent was taken. Results: As per Japanese Orthopaedic Association score, Normal results were observed in none of the cases while grade I, II and III was observed in 73.5%, 20.6% and 5.9% cases. Post-op results were observed as normal in 64.7% while Grade I, II and III was observed in 32.4% and 2.9% cases respectively (p<0.01). Conclusion: Present study concluded that although, long-term role of deformity correction and restoration of lumbar spinal balance in cases of spondylolisthesis is yet to be determined, the current study appears to indicate that satisfactory radiological correction of degenerative focal sagittal deformity can be achieved with the insert and-rotate PLIF technique. There appeared to be high levels of patient satisfaction in this relatively short-term study and low levels of complications. Longer-term and comparative clinical outcome studies are required.
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References
- Dantas FL, Prandini MN, Ferreira MA. Comparison between posterior lumbar fusion with pedicle screws and posterior lumbar interbody fusion with pedicle screws in adult spondylolisthesis. Arq Neuropsiquiatr. 2007; 65(3B):764-70. https://doi.org/10.1590/S0004-282X2007000500006. PMid:17952277 DOI: https://doi.org/10.1590/S0004-282X2007000500006
- Frymoyer JW, Selby DK. Segmental instability, Rational for treatment. Spine. 1985; 15:1216-26.
- Meyrding HW. Spondylolisthesis. Surg Gynecol Obstet. 1932; 54:371-7.
- Roy-Camille R, Demeulenaere C. Osteosynthese du rachis dorsal, lombaire et lombo-sacre par plaques metalliqyes vissees dans less pedicules vertebraux et les apophyses articulaires. Presse Med. 1970; 78:1447-50.
- Zdeblick TA. A prospective, randomized study of lumbar fusion. Spine 1993; 18:983-91. https://doi.org/10.1097/00007632-199306150-00006. PMid:8367786 DOI: https://doi.org/10.1097/00007632-199306150-00006
- Dai LY, Jia LS, Yuan W. Direct repair of defect in lumbar spondylolysis and mild isthmic spondylolisthesis by bone grafting, with or without joint fusion. Eur Spine J. 2001; 10:78-83. https://doi.org/10.1007/s005860000205. PMid:11276840 PMCid:PMC3611468 DOI: https://doi.org/10.1007/s005860000205
- Feffer HL, Wiesel SW, Cuckler JM, Rothman RH. Degenerative spondylolisthesis: To fuse or not to fuse. Spine 1985; 10:78-83. https://doi.org/10.1097/00007632-198504000-00018 DOI: https://doi.org/10.1097/00007632-198504000-00018
- Enker P, Steffee AD. Interbody fusion and instrumentation. Clin Orthop Relat Reser 1994; 300:90-1. https://doi.org/10.1097/00003086-199403000-00011 DOI: https://doi.org/10.1097/00003086-199403000-00011
- Evans JH. Biomechanics of lumbar fusion. Clin Orthop Relat Reser 1985; 193:38-46. https://doi.org/10.1097/00003086198503000-00005 DOI: https://doi.org/10.1097/00003086-198503000-00005
- Cloward R. The treatment of ruptured intervertebral discs by vertebral body fusion. Indications, operation technique after care. J Neurosurg. 1953; 10:154-68. https://doi.org/10.3171/jns.1953.10.2.0154. PMid:13035484 DOI: https://doi.org/10.3171/jns.1953.10.2.0154
- Cheng L, Nie L, Zhang L. Posterior lumbar interbody fusion versus posterolateral fusion in spondylolisthesis: A prospective controlled study in the Han nationality. Int Orthop. 2009; 33:1043-7. https://doi.org/10.1007/s00264008-0588-x. PMid:18521599 PMCid:PMC2898976 DOI: https://doi.org/10.1007/s00264-008-0588-x
- Cho KS, Kang SG, Yoo DS, Huh PW, Kim DS, Lee SB. Risk factors and surgical treatment for symptomatic adjacent segment degeneration after lumbar spine fusion. J Korean Neurosurg Soc. 2009; 46:425-30. https://doi.org/10.3340/jkns.2009.46.5.425. PMid:20041051 PMCid:PMC2796347 DOI: https://doi.org/10.3340/jkns.2009.46.5.425
- Miwa T, Sakaura H, Yamashita T, Suzuki S, Ohwada T. Surgical outcomes of additional posterior lumbar interbody fusion for adjacent segment disease after single-level posterior lumbar interbody fusion. Eur Spine J. 2013; 22:286. https://doi.org/10.1007/s00586-013-2863-9. PMid:23775291 PMCid:PMC3843783 DOI: https://doi.org/10.1007/s00586-013-2863-9