The results of the Posterior Lumbar Interboby Fusion using Titanium mesh cage for Spondylolisthesis

Choy, Won Sik; Kim, Whoan Jeang; Kim, Kyou Hyeun; Kim, Young Wan; Keum, Teok Seop; Lee, Byeong Ki; Ryu, Chang Soo

Abstract

STUDY DESIGN: This is a retrospective study analysing and comparing what between posterior lumbar interbody fusion plus posterior lateral fusion(PLIF+PLF) and PLF alone for Spondylolisthesis(Degenerative type+Isthmic type). Thirty patients were treated by posterior lumbar interbody fusion(PLIF) using Harms' cage and posterolateral fusion(PLF) with transpedicular screw fixation. Forty-nine patients were treated by posterolateral fusion with transpedicular screw fixation.
OBJECTIVES
This is to verify the advantages of adding posterior lumbar interbody fusion using Harms' cage to the usual posterolateral fusion with transpedicular screw fixation SUMMARY OF BACKGROUND DATA: Interbody fusions have certain distinct mechanical advantages over posterolateral ones. Autologous cancellous bone is the preferred graft material, but might be soft to maintain the disc space during fusion.
METHODS
Union rate, slip reduction, sagittal angle correction, disc height restoration, and clinical results by Lin's criteria were analysed.
RESULTS
Nonunion was observed in 5 PLF cases(10%) and one PLIF case(3%). Loss of slip reduction was 0.7% in PLIF and 2.59% in PLF(P<0.05). Loss of sagittal angle correction was 1.27degreein PLIF and 3.65degreein PLF(P<0.05). Loss of disc height restoration was 2.6% in PLIF and 7.6% in PLF(P<0.05). Clinical evaluation in PLIF+PLF was excellent in 67%, good in 30%, and fair in 3%. Clinical evaluation in PLF was excellent in 59%, good in 33%, and fair in 8%. More excellent results were noted in PLIF+PLFcases.
CONCLUSIONS
Adding posterior lumbar interbody fusion using Harms' cage showed better radiological results and more excellent clinical results compared to posterolateral fusion with transpedicular screw fixation.