J Korean Soc Spine Surg.  2007 Mar;14(1):34-43. 10.4184/jkss.2007.14.1.34.

Minimum 5 Year Results of Posterior Lumbar Interbody Fusion with Cages in Lumbar Spondylolisthesis

• Chung JY
• Seo HY
• Lee JJ
• Kang KD

• KMID: 1527141
• DOI: http://doi.org/10.4184/jkss.2007.14.1.34

Abstract

STUDY DESIGN: A retrospective study
OBJECTIVES
To examine the mid term clinical and radiologic findings of patients treated by Posterior Lumbar Interbody Fusion (PLIF) with cages in spondylolisthesis. LITERATURE REVIEW: The clinical result of PLIF with cages is satisfactory. PLIF with cages is a useful treatment for spondylolisthesis.
MATERIALS AND METHODS
Forty-two patients were followed up for more than 5 years. Their mean age was 53 years and the mean follow-up period was 68 months. Twenty-one cases were the isthmic type, and 21 cases were the degenerative type. The low back pain score, Lin s clinical result, perioperative value of slippage, anterior intervertebral disc space height, radiological change in the adjacent level and complications were evaluated.
RESULTS
The preoperative lower back pain score improved from 46.7 to 86.4 points at the last follow-up (p.0.05). Thirty-eight patients (91%) showed excellent or good results. The preoperative value of slippage improved from 17.5% to 5.7% (p.0.05). The anterior intervertebral disc space height increased from 10.0 to 14.5 mm (p.0.05). There were changes in the above and lower adjacent segments in 12 cases (28%). Two of these cases required surgery.
CONCLUSIONS
PLIF with cages might be an effective method in spondylolisthesis. However, the long-term follow-up showed changes in the adjacent segment.

Keyword

Spondylolisthesis; Posterior lumbar interbody fusion; Follow-up

MeSH Terms

Follow-Up Studies
Humans
Intervertebral Disc
Low Back Pain
Retrospective Studies
Spondylolisthesis*

Figure

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  Fig. 1. (A) Lateral radiograph of a 48-year-old woman with spondylolytic spondylolisthesis at L4-5. (B) Immediate postoperative lateral radiograph shows good reduction. (C1) Flexion view, (C2) extension view of lateral radiograph at 5 years followup show solid interbody fusion in L4-5 and adjacent degenerative spondylolisthesis at L5-S1.

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  Fig. 2. (A) Lateral radiograph of a 52-year-old male with degenerative spondylolisthesis at L4-5. (B) Immediate postoperative lateral radiograph. (C1) Flexion view, (C2) extension view of lateral radiograph at 5 years followup show segmental instability(15。) at L5-S1.

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  Fig. 3. (A) Lateral radiograph of a 37-year-old male with spondylolytic spondylolisthesis at L4-5. (B) Immediate postoperative lateral radiograph. (C) 5 years followup CT myelograph shows herniated nucleus pulposus at L5-S1. (D) The 2nd postoperative lateral radiograh shows PLIF L5-S1 with cages for the herniated nucleus pulposus at L5-S1.

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