In some of the lumbar spinal disorders, fusion is the method of choice for relieving spinal pain and usually one or two segments fusion is sufficient but sometimes as in degenerative spinal stenosis it is necessary to carry out three or more
segments
fusion.
The purpose of this study is to compare the clinical results between these short and long segment fusion groups.
From August 1987 to December 1992, 138 lumbar spinal disorders were operated on the followed for more than one year, the average follow up period was 2 years and 5 months. One or two segments fusion was carried out in 111 patients and three or
more
segments fusion in 27 patients. 49 patients were male and 89 patients were female. Most prevalent age was from 41 to 60 in both groups. Degenerative spinal stenosis was the most common etiology for operation in both groups.
In all cases, pedicle screws were inserted and abundant autogenous iliac bone graft was done. Average operation time was 4.75 hours in short segment fusion group and 6.25 hours in long segment fusion group. under the hypotensive anesthesia, the
amount
of blood loss during operation was 1520㎖ and 2000㎖ respectively, and the amount of postoperative suction drainage was 450㎖ and 730㎖ respectively.
On clinical results, 96.4% of good to excellent results were obtained in short segment fusion group while in ling segment fusion group it was 85.2% but overall clinical results had no statistical significance between these two groups.
In complications, hematoma was the most frequent complication in both groups but it was more frequent in long segment fusion group. Dural tear occured in 5 patients and it was more frequent in long segment fusion group and this was the only
statistically significant complication. In this series, we had no deep wound infection, no nonunion and no permanant neurologic deficit.
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