The Clinical Outcomes Of Posterior Lumbar Interbody Fusion With A Follow-up Of At Least 5 Years

Objective To our knowledge, the clincal outcomes after posterior lumbar interbody fusion (PLIF) with a follow-up of at least 5 years are not available in China at present. The aim of this paper was to evaluate the clinic outcomes of the PLIF combined with combined with two pedicle screws instrumentation, using autogenous appendixes bone of vertebrae lumbales and two cages for chronic low back pain disease in a minimum span of 5-year follow-up.Methods The date of all patients were collected including the cases, pre-operative and 1-,3-,5-year post-operative X-rays, and Oswestry Disability Index (ODI). The rates of fusion and adjacent segment degeneration (ASD) were calculated after observing and measuring the X-rays.Results Eighty-four patients with a minimum follow-up of 5 years were included, including 37 males and 47 females, and the mean age was 50.69 years old (aging 28-80 years), with the mean follow-up being 64.5 months (60-71). Sixty-two cases were one-level, nineteen cases were two-level, and three cases were three-level fusions.The pre-operative and 1-,3-,5-year post-operative ODI was 55.47±14.21,8.49±3.64,8.73±4.22 respectively. Nineteen patients were remained lumbar discomfort (11 in single level fusion,8 in multyple level fusions). ASD occured in 16 patients in at least 5 years'follow-up, and two of them had symptoms, signs and incresaed ODI. None of petiens needed revision operation because of ASD.Conclusions There were significant difference between preoperative ODI and 1-year postoperative (P<0.01), or 5-year postoperative ODI (P<0.01). There was no statistical difference between 1-year and 5-year postoperative ODI(P>0.05). The fusion rate was 94.95% (103/109),100%(109/109) respectively at the end of 1-year,3-year postoperation. The rate of lumbar discomfort was 22.61% (19/84) and ASD was 19.04% (16/84) in at least 5 years'follow-up. The rate of ASD which had symptoms, signs and incresaed ODI was 2.38%(2/84). The difference of the rates of lumbar discomfort were not found between the patients who underwent single level fusion and multiple level fusions.