Posterior Lumbar Interbody Fusion Versus 360degrees Fixation in Degenerative Lumbar Diseases

Lee, Nok Young; Oh, Seong Hoon; Rhee, Woo Tack; Bae, Jae Seong; Yi, Hyeong Joong; Kim, Young Soo; Ko, Yong; Kim, Kwang Myung; Oh, Suck Jun

Abstract

OBJECTIVES
The goal of operation for degenerative lumbar diseases is to relieve radiculopathy and low back pain and to prevent further degeneration. The authors analyzed the surgical results of posterior lumbar interbody fusion(PLIF) and 360degrees fixation to evaluate the proper treatment policy in spinal stenosis, degenerative spondylolisthesis and low grade isthmic spondylolisthesis. MATERIAL AND METHODS: The authors performed PLIF on 92 patients and 360degrees fixation on 138 patients with spinal stenosis, degenerative spondylolisthesis and low grade isthmic spondylolisthesis. We retrospectively studied clinical outcomes and subjective satisfaction of these patients by several criteria such as visual analog scale(VAS), Prolo's economic and functional outcome scale, medication usage after operation and questionaire for overall outcome. RESULT: Pre- and postoperative VAS on back pain and leg pain showed decrease of pain from 6.5, 6.7 to 2.2, 2.4 in PLIF group and from 7.0, 7.2 to 2.5, 2.7 in 360degrees fixation group. Excellent and good outcomes on Prolo's scale were 81.5% in PLIF group and 82.6% in 360degrees fixation group. Medication usage after operation was reduced in 79.3% of PLIF group and in 78.3% of 360degrees fixation group. Patients' self-reported overall success of their procedure showed 82% in PLIF group and 84% in 360degrees fixation group.
CONCLUSION
Both PLIF and 360degrees fixation showed good outcomes and provided biomechanically stable fusion in spinal stenosis, degenerative spondylolisthesis and low grade isthmic spondylolisthesis. Therefore, only PLIF seems necessary and considered a proper surgical treatment for these disorders.