Posterior Lumbar Interbody Fusion(PLIF) by Facetolaminoplasty in Lumbar Spine Revision Surgery.
- Author:
Byung Yoon JUN
1
Author Information
1. Department of Neurosurgery, College of Medicine Inha University, Incheon, Korea.
- Publication Type:Original Article
- Keywords:
Facetolaminotomy;
PLIF;
revision;
Screw fixation
- MeSH:
Arthrodesis;
Carbon;
Follow-Up Studies;
Humans;
Spine*
- From:Journal of Korean Neurosurgical Society
1999;28(12):1746-1754
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: There has been a lack of enthusiasm for posterior lumbar interbody fusion(PLIF) in revision surgery. PLIF in revision surgery requires more excessive distraction of neural structures and excessive removal of the facet-laminar structure which plays a significant mechanical role, especially in rotatory stability. The author reports facetolaminoplastic PLIF which provides safe and effective PLIF and even natural circumferential fusion as well. PATIENTS AND METHODS: This study consistes of 6 patients. The facetolaminotomy was performed by osteotomizing bilateral pars interarticularis with a Gigli saw. PLIF was performed through more widely exposed intervertebral space by inserting a pair of carbon fiber cages and medial iliac bone blocks between the cages. The facetolaminotomy flap was returned to the previous site and was fixed by trans-laminar and trans-isthmic screw fixation. Bilateral facet arthrodesis was also performed. RESULTS: There were no neural complications related to facetolaminotomy nor were there any complications related to the screw fixation for the restoration of the posterior construct. Of these 6 cases, radiological union at the interbody fusion site and at both pars interarticularis was noted in 5 cases at a 6-month postoperative follow-up. An incomplete union at unilateral pars interarticularis was noted in remaining one case. CONCLUSIONS: The PLIF by facetolaminoplasty in revision surgery not only provides a wide interspace for safe and effective PLIF but also restores the posterior constructs, thereby preserving its important mechanical roles and often even achieving natural circumferential arthrodesis.
