J Korean Orthop Assoc.  2009 Feb;44(1):102-108. 10.4055/jkoa.2009.44.1.102.

Posterior Lumbar Interbody Fusion and Unilateral Posterolateral Fusion with Local Bone and Single Cage: Comparison with Posterolateral Lumbar Fusion and Autologous Iliac Bone

• Yoon YH
• Cho KJ
• Park SR
• Moon KH
• Lee TJ
• Park HB

• KMID: 2186384
• DOI: http://doi.org/10.4055/jkoa.2009.44.1.102

Abstract

PURPOSE
To evaluate the effectiveness of posterior lumbar interbody fusion (PLIF) using a single cage and unilateral posterolateral fusion (PLF) with local bone, and to compare the clinical and radiological results with those of posterolateral lumbar fusion (PLF) with autologous iliac bone.
MATERIALS AND METHODS
Fifty patients with single segment degenerative lumbar disease were treated with spinal fusion. Twenty six patients, who underwent PLIF with single cage and local bone without autologous iliac bone, were classfied as the "cage group". The other 24 patients, who underwent PLF using autologous iliac bone, were classified as the "PLF group". The fusion rate, lumbar lordortic angle, segmental angle, and intervertebral disc height were compared in the radiograph between the two groups. The clinical outcomes were evaluated by the Oswestry Disability Index. Statistical analysis was performed using a T-test and Chi-Square test.
RESULTS
The bony fusion rate was 80.8% in the cage group and 83.3% in the PLF group. The intervertebral disc height was restored better in the cage group, but there was no statistical difference between the two groups (p=0.10). Average intraoperative blood loss was similar in the two groups (565 ml in the cage group vs 567 ml in the PLF group). The average operation time was longer in the cage group but the difference was not significant (146.7 min vs 134 min). In the PLF group, 22 patients experienced pain at the iliac graft donor site in the early postoperative period that persisted for more than 6 months in 5 patients.
CONCLUSION
PLIF using a single cage and local bone for single segment degenerative lumbar disease produced satisfactory bony fusion with none of the donor site morbidity at the iliac bone.

Keyword

Posterior lumbar interbody fusion; Local bone; Single cage

MeSH Terms

Humans
Intervertebral Disc
Postoperative Period
Spinal Fusion
Tissue Donors
Transplants

Figure

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  Fig. 1 Diagram of posterior lumbar interbody fusion using single cage and unilateral posterolateral fusion with local bone.

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  Fig. 2 A 65-year-old female had spinal stenosis at L4-5. (A, B) She was performed posterior lumbar interbody fusion and unilateral posterolateral fusion with local bone and single cage. The radiograph shows solid fusion mass on L4-5 two years after operation.

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  Fig. 3 A 51-year-old female had spinal stenosis at L4-5. (A, B) She was performed posterior lumbar interbody fusion and unilateral posterolateral fusion with local bone and single cage. The radiograph shows solid fusion mass on L4-5 one year after operation.

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