Posterior Lumbar Interbody Fusion via a Unilateral Approach.
10.3349/ymj.2006.47.3.319
- Author:
Hyun Chul SHIN
1
;
Seong YI
;
Keung Nyun KIM
;
Sang Hyun KIM
;
Do Heum YOON
Author Information
1. Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea. knkim@yumc.yonsei.ac.kr
- Publication Type:Original Article ; Clinical Trial ; Research Support, Non-U.S. Gov't
- Keywords:
Posterior lumbar interbody fusion (PLIF);
unilateral approach;
instability
- MeSH:
Treatment Outcome;
Spinal Fusion/*methods;
Middle Aged;
Male;
Lumbar Vertebrae/radiography/*surgery;
Joint Instability/radiography/*surgery;
Intervertebral Disk Displacement/radiography/*surgery;
Humans;
Follow-Up Studies;
Female;
Adult
- From:Yonsei Medical Journal
2006;47(3):319-325
- CountryRepublic of Korea
- Language:English
-
Abstract:
This study sought to determine the outcomes of posterior lumbar interbody fusion (PLIF), via a unilateral approach, in selected patients who presented with unilateral leg pain and segmental instability of the lumbar spine. Patients with a single level of a herniated disc disease in the lumbar spine, unilateral leg pain, chronic disabling lower back pain (LBP), and a failed conservative treatment, were considered for the procedure. A total of 41 patients underwent a single-level PLIF using two PEEK(TM) (Poly-Ether-Ether-Ketone) cages filled with iliac bone, via a unilateral approach. The patients comprised 21 women and 20 men with a mean age of 41 years (range: 22 to 63 years). Two cages were inserted using a unilateral medial facetectomy and a partial hemilaminectomy. At follow-up, the outcomes were assessed using the Prolo Scale. The success of the fusion was determined by dynamic lumbar radiography and/or computerized tomography scanning. All the patients safely underwent surgery without severe complications. During a mean follow-up period of 26 months, 1 patient underwent percutaneous pedicle screw fixation due to persistent LBP. A posterior displacement of the cage was found in one patient. At the last follow up, 90% of the patients demonstrated satisfactory results. An osseous fusion was present in 85% of the patients. A PLIF, via a unilateral approach, enables a solid union with satisfactory clinical results. This preserves part of the posterior elements of the lumbar spine in selected patients with single level instability and unilateral leg pain.
