Fusion Rate and Clinical Outcomes in 2-level Posterior Lumbar Interbody Fusion.

Fusion Rate and Clinical Outcomes in 2-level Posterior Lumbar Interbody Fusion.

World Neurosurg. 2018 Jan 17;:

Authors: Aono H, Takenaka S, Nagamoto Y, Tobimatsu H, Yamashita T, Furuya M, Iwasaki M

Abstract
BACKGROUND: Posterior lumbar interbody fusion (PLIF) has become a general surgical method for degenerative lumbar diseases. Although many reports have focused on single-level PLIF, few have focused on 2-level PLIF, and no report has covered the fusion status of 2-level PLIF. The purpose of this study is to investigate clinical outcomes and fusion for 2-level PLIF by using a combination of dynamic radiographs and multiplanar-reconstruction computed tomography scans.
METHODS: This study consists of 48 consecutive patients who underwent 2-level PLIF for degenerative lumbar diseases. We assessed surgery duration, estimated blood loss, complications, clinical outcomes as measured by the Japanese Orthopaedic Association (JOA) score, lumbar sagittal alignment as measured on standing lateral radiographs, and fusion status as measured by dynamic radiographs and multiplanar-reconstruction computed tomography. Patients were examined at a follow-up point of 4.8±2.2 years after surgery. Thirty-eight patients who did not undergo lumbosacral fusion comprised the LL group, and 10 patients who underwent lumbosacral fusion comprised the LS group.
RESULTS: The mean JOA score improved from 12.1 to 22.1 points by the final follow up examination. Sagittal alignment was also improved. All patients had fusion in the cranial level. Seven patients had nonunion in the caudal level, and the LS group (40%) had a significantly poorer fusion rate than the LL group (97%) did.
CONCLUSIONS: Surgical outcomes of 2-level PLIF were satisfactory. The fusion rate at both levels was 85%. All nonunion was observed at the caudal level and concentrated at L5-S level in L4-5-S PLIF.

PMID: 29355805 [PubMed - as supplied by publisher]

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