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KMID : 1099620070040030123
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Korean Journal of Spine
2007 Volume.4 No. 3 p.123 ~ p.128
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Long-term Results of Single Level Posterior Lumbar Interbody Fusion with Stand-alone Cage in Degenerative Spine Diseases
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Park Kwang-Woo
Kim Woo-Kyung
Park Chan-Woo
Yoo Chan-Jong
Kim Dae-Yong
Lee Sang-Gu
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Abstract
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Objectives: Posterior lumbar interbody fusion(PLIF) surgeries have been done for many years for the treatment of degene- rative lumbar diseases. There is controversy regarding the use of interbody fusion cages as stand-alone devices in patients with degenerative disk disease. A clinical comparison was made between a stand-alone cage procedure and cages with pedicle screw procedure.
Methods: From January 2000 to June 2004, this retrospective review was compared 2 data sets, including consecutive patients who were diagnosed with degenerative lumbar disease and were fused to the lumbar spine using a posterior approach. Surgical and hospital details, patient demographics, and Prolo scores were collected. And we checked that fusion rates and change of disc heights were measured. All statistical analyses were performed by using SPSS software version 11.5(SPSS Institute Inc., Chicago, IL).
Results:The stand-alone group included 34 patients(16 male and 18 female). And the posterior fixation group included 45 patients(16 male and 29 female).The mean age of the stand-alone group was 43.7 years and of the posterior fixation group 46.3 years. The mean follow-up period was 58.6 months in the stand-alone cage group and 60.2 months in the posterior fixation group. Both groups showed significant improvement in back and leg pain after surgery. There were no statistically significant differences in Prolo score. Postoperative complications and revisions were 15.5% in the pedicle screw group compared with 5.9% in the stand-alone group. The stand-alone group resulted in shorter operative time and less blood loss. Fusion rates were measured 91.4% in the stand-alone group and 93.3% in the pedicle screw group. The average of disc height was decreased to 2.4mm in stand-alone group. But the prognosis was not worsen in spite of prominent subsidence.
Conclusion: PLIF with stand-alone cage was a useful technique for achieving spinal fusion and have been shown to have an acceptable clinical success rate in appropriately selected patients.
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KEYWORD
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Stand-alone cage, PLIF, Pedicle screw, Long-term results
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