The Posterior Decompression and Posterior Lumbar Interbody Fusion Using a Mini-open Technique: New Suggestion of Minimally Invasive Technique A Preliminary Report

Kim, Ki Tack; Suk, Kyung Soo; Lee, Young Ho; Kim, Young Woo; Lee, Sang Hun

Abstract

PURPOSE
To introduce mini-open posterior decompression with posterior lumbar interbody fusion (PLIF) and to assess its clinical outcomes. MATERIALS AND METHODS: Eight patients who underwent L4-5 posterior decompression with PLIF using a mini-open technique were followed up for an average 8 months. Three patients had degenerative lumbar spinal stenosis and five patients had spinal stenosis with degenerative spondylolisthesis. We performed posterior decompression with PLIF through a mini-incision (2.5 cm paramedian incision at the both sides) including percutaneous pedicle screw fixation. The operative time, amount of blood loss and complications were analyzed. Clinical outcomes were assessed by using McNab criteria and VAS (visual analogue scale) for postoperative back pain. RESULTS: The mean operative time was 172.5 min (range, 130-235 min). The mean amount of intraoperative blood loss was 178.1 mL (range, 95-310 mL). All procedures were completed without transfusion. VAS for back pain rapidly reduced from 10 on the immediate postoperative day to 3 on the third day and 2 on the seventh day. At the last follow up, five patients had no back pain and the three remaining patients had a VAS 0.75. The clinical outcomes were excellent in 5 patients and good in 3 patients. CONCLUSION: Mini-open posterior decompression and the PLIF technique offer a useful minimally-invasive modality for the treatment of single level spinal stenosis.