Comparison Of3Fusion Methods In Single-level Low Lumbar Degenerative Disease

Objective: To observe and compare the efficacy of lumbar posterolateral fusion(PLF)，posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbodyfusion (TLIF) in the treatment of single-level low lumbar degenerative disease．Methods: Between January2008and August2011，the follow-up complete data of73patients who underwent fusion surgery because of single-leve low lumbar degenerativedisease were retrospectively analysed．The patients were divided into3groups：group A(PLF, n=21)；group B (PLIF, n=21)；group C (TLIF, n=25)．A visual analog scale(VAS)and the Chinese Oswestry Disability Index(ODI) were used to measure low back pain, legpain, and disability．For X-ray evaluation, instrumented breakage、lumbar lordosis、maintenance of disc height were analyzed．Bone fusion was examined by two-dimensionalreconstruction of CT．Results: All patients were followed up for average of27months(range，18months～62months)．All methods indicated significant improvement in clinical assessments,using Oswestry、VAS for low back pain and leg pain(P<0.05)；no statistical differenceswere found among the3groups (P>0.05)．On radiologic assessment, the fusion ratesrespectively were85.7%,100%and100%with significant differences (P<0.05)．Furthercomparing the fusion rates of B,C with A, significant differences existed (P<0.05); nosignificant difference existed comparing B and C(P>0.05)．The incidence of broken nailsand lumbar lordosis in the3fusion methods had no statistically significantdifferences(P>0.05)．Statistical differences were found Between B、C and the A groups inthe relative disc height (P <0.05), indicating that A group having the highest loss in discheight,there was no significant difference between B and the C groups．Conclusion: No significant differences in clinical results were found among the3 fusion methods in our observation，all are equally suitable for treating single-level lowlumbar degenerative disease．However，the fusion rates of TLIF and PLIF are better thanPLF．TLIF and PLIF have significant advantages in the correction and maintenance of discheight．TLIFand PLIF should be given priority to in the treatment of in single-level lowlumbar degenerative disease．...