Radiological and Clinical Comparison of Posterolateral Fusion and Transforaminal Interbody Fusion Techniques in Degenerative Lumbar Stenosis

2018 ◽  
Vol 116 ◽  
pp. e1060-e1065 ◽  
Author(s):  
Gokhan Bozkurt ◽  
Ilkay Isikay ◽  
Sahin Hanalioglu
Keyword(s):  
Interbody Fusion ◽  
Posterolateral Fusion ◽  
Lumbar Stenosis ◽  
Clinical Comparison ◽  
Transforaminal Interbody Fusion

Long-term outcome of fusion for degenerative disc disease in the lumbar spine

2019 ◽  
Vol 101-B (12) ◽  
pp. 1526-1533 ◽  
Author(s):  
Peter Endler ◽  
Per Ekman ◽  
Ivan Berglund ◽  
Hans Möller ◽  
Paul Gerdhem
Keyword(s):  
Back Pain ◽  
Lumbar Spine ◽  
Degenerative Disc Disease ◽  
Interbody Fusion ◽  
Patient Reported Outcome ◽  
Posterolateral Fusion ◽  
Disc Disease ◽  
Degenerative Disc ◽  
Additional Surgery ◽  
Patient Reported

AimsChronic low back pain due to degenerative disc disease is sometimes treated with fusion. We compared the outcome of three different fusion techniques in the Swedish Spine Register: noninstrumented posterolateral fusion (PLF), instrumented posterolateral fusion (IPLF), and interbody fusion (IBF).Patients and MethodsA total of 2874 patients who were operated on at one or two lumbar levels were followed for a mean of 9.2 years (3.6 to 19.1) for any additional lumbar spine surgery. Patient-reported outcome data were available preoperatively (n = 2874) and at one year (n = 2274), two years (n = 1958), and a mean of 6.9 years (n = 1518) postoperatively and consisted of global assessment and visual analogue scales of leg and back pain, Oswestry Disability Index, EuroQol five-dimensional index, 36-Item Short-Form Health Survey, and satisfaction with treatment. Statistical analyses were performed with competing-risks proportional hazards regression or analysis of covariance, adjusted for baseline variables.ResultsThe number of patients with additional surgery were 32/183 (17%) in the PLF group, 229/1256 (18%) in the IPLF group, and 439/1435 (31%) in the IBF group. With the PLF group as a reference, the hazard ratio for additional lumbar surgery was 1.16 (95% confidence interval (CI) 0.78 to 1.72) for the IPLF group and 2.13 (95% CI 1.45 to 3.12) for the IBF group. All patient-reported outcomes improved after surgery (p < 0.001) but were without statistically significant differences between the groups at the one-, two- and 6.9-year follow-ups (all p ≥ 0.12).ConclusionThe addition of interbody fusion to posterolateral fusion was associated with a higher risk for additional surgery and showed no advantages in patient-reported outcome Cite this article: Bone Joint J 2019;101-B:1526–1533

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