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Comparison of Posterior Lumbar Interbody Fusion and Posterolateral Lumbar Fusion in Monosegmental Vacuum Phenomenon within an Intervertebral Disc.

An KC, Kong GM, Park DH, Baik JM, Youn JH, Lee WS - Asian Spine J (2016)

Bottom Line: LVAS, BVAS, and ODI improved in both groups.There was no significant difference in the degree of these improvements between PLIF and PLF patients (p>0.05).No significant differences in clinical results and union rates were found between PLIF and PLF patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

ABSTRACT

Study design: Retrospective.

Purpose: To compare the clinical and radiological outcomes of posterolateral lumbar interbody fusion (PLIF) and posterolateral lumbar fusion (PLF) in monosegmental vacuum phenomenon within an intervertebral disc.

Overview of literature: The vacuum phenomenon within an intervertebral disc is a serious form of degenerative disease that destabilizes the intervertebral body. Outcomes of PLIF and PLF in monosegmental vacuum phenomenon are unclear.

Methods: Monosegmental instrumented PLIF and PLF was performed on 84 degenerative lumbar disease patients with monosegmental vacuum phenomenon (PLIF, n=38; PLF, n=46). Minimum follow-up was 24 months. Clinical outcomes of leg and back pain were assessed using visual analogue scales for leg pain (LVAS) and back pain (BVAS), and the Oswestry disability index (ODI). The radiographic outcome was the estimated bony union rate.

Results: LVAS, BVAS, and ODI improved in both groups. There was no significant difference in the degree of these improvements between PLIF and PLF patients (p>0.05). Radiological union rate was 91.1% in PLIF group and 89.4% in PLF group at postoperative 24 months (p>0.05).

Conclusions: No significant differences in clinical results and union rates were found between PLIF and PLF patients. Selection of the operation technique will reflect the surgeon's preferences and patient condition.

No MeSH data available.


Related in: MedlinePlus

Posterior lumbar interbody fusion. (A) Preoperative L-spine standing anteroposterior view and (B) L-spine standing lateral view radiographs, vacuum phenomenon (white arrow). (C) Postoperative L-spine standing anteroposterior view and (D) L-spine standing lateral view radiographs.
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Figure 1: Posterior lumbar interbody fusion. (A) Preoperative L-spine standing anteroposterior view and (B) L-spine standing lateral view radiographs, vacuum phenomenon (white arrow). (C) Postoperative L-spine standing anteroposterior view and (D) L-spine standing lateral view radiographs.

Mentions: The mean follow-up duration was 24.5 months (range, 24–26 months). Eighty four patients (17 males, 67 females; mean age, 62.5 years; age range, 41–73 years) with monosegmental intervertebral disc vacuum phenomenon were operated on by one senior author (K.C.A.) using posterior decompression and instrumentation PLIF (n=38) (Fig. 1) or PLF (n=46) (Fig. 2). The operative time was 171±51 minutes in the PLIF group and 163±42 minutes in the PLF group. Intraoperative blood loss volume was 691±163 mL in the PLIF group and 640±172 mL in the PLF group. Although the operative time was longer and the estimated blood loss was and larger in the PLF group than the PLIF group, the difference were not statistically significant (p=0.159 and p=0.301, respectively). In addition, there were no statistically significant differences between the two groups in terms of sex and age (p=0.276 and p=0.353, respectively). In the PLIF and PLF group, the fusion occurred at L4–L5 in 17 (45%) and 21 (46%) cases, respectively, and at L5–S1 in 21 (55%) and 25 (54%) cases, respectively. In terms of the level at which the fusion occurred, no statistically significant differences were found between the two groups (p=0.874) (Table 1).


Comparison of Posterior Lumbar Interbody Fusion and Posterolateral Lumbar Fusion in Monosegmental Vacuum Phenomenon within an Intervertebral Disc.

An KC, Kong GM, Park DH, Baik JM, Youn JH, Lee WS - Asian Spine J (2016)

Posterior lumbar interbody fusion. (A) Preoperative L-spine standing anteroposterior view and (B) L-spine standing lateral view radiographs, vacuum phenomenon (white arrow). (C) Postoperative L-spine standing anteroposterior view and (D) L-spine standing lateral view radiographs.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4764547&req=5

Figure 1: Posterior lumbar interbody fusion. (A) Preoperative L-spine standing anteroposterior view and (B) L-spine standing lateral view radiographs, vacuum phenomenon (white arrow). (C) Postoperative L-spine standing anteroposterior view and (D) L-spine standing lateral view radiographs.
Mentions: The mean follow-up duration was 24.5 months (range, 24–26 months). Eighty four patients (17 males, 67 females; mean age, 62.5 years; age range, 41–73 years) with monosegmental intervertebral disc vacuum phenomenon were operated on by one senior author (K.C.A.) using posterior decompression and instrumentation PLIF (n=38) (Fig. 1) or PLF (n=46) (Fig. 2). The operative time was 171±51 minutes in the PLIF group and 163±42 minutes in the PLF group. Intraoperative blood loss volume was 691±163 mL in the PLIF group and 640±172 mL in the PLF group. Although the operative time was longer and the estimated blood loss was and larger in the PLF group than the PLIF group, the difference were not statistically significant (p=0.159 and p=0.301, respectively). In addition, there were no statistically significant differences between the two groups in terms of sex and age (p=0.276 and p=0.353, respectively). In the PLIF and PLF group, the fusion occurred at L4–L5 in 17 (45%) and 21 (46%) cases, respectively, and at L5–S1 in 21 (55%) and 25 (54%) cases, respectively. In terms of the level at which the fusion occurred, no statistically significant differences were found between the two groups (p=0.874) (Table 1).

Bottom Line: LVAS, BVAS, and ODI improved in both groups.There was no significant difference in the degree of these improvements between PLIF and PLF patients (p>0.05).No significant differences in clinical results and union rates were found between PLIF and PLF patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

ABSTRACT

Study design: Retrospective.

Purpose: To compare the clinical and radiological outcomes of posterolateral lumbar interbody fusion (PLIF) and posterolateral lumbar fusion (PLF) in monosegmental vacuum phenomenon within an intervertebral disc.

Overview of literature: The vacuum phenomenon within an intervertebral disc is a serious form of degenerative disease that destabilizes the intervertebral body. Outcomes of PLIF and PLF in monosegmental vacuum phenomenon are unclear.

Methods: Monosegmental instrumented PLIF and PLF was performed on 84 degenerative lumbar disease patients with monosegmental vacuum phenomenon (PLIF, n=38; PLF, n=46). Minimum follow-up was 24 months. Clinical outcomes of leg and back pain were assessed using visual analogue scales for leg pain (LVAS) and back pain (BVAS), and the Oswestry disability index (ODI). The radiographic outcome was the estimated bony union rate.

Results: LVAS, BVAS, and ODI improved in both groups. There was no significant difference in the degree of these improvements between PLIF and PLF patients (p>0.05). Radiological union rate was 91.1% in PLIF group and 89.4% in PLF group at postoperative 24 months (p>0.05).

Conclusions: No significant differences in clinical results and union rates were found between PLIF and PLF patients. Selection of the operation technique will reflect the surgeon's preferences and patient condition.

No MeSH data available.


Related in: MedlinePlus