A STUDY OF POSTERIOR LUMBAR INTERBODY FUSION WITH LOCALLY HARVESTED SPINOLAMINECTOMY BONE GRAFT AND PEDICLE SCREW FIXATION IN SPONDYLOLISTHESIS
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 66
Abstract
BACKGROUND Posterior Lumbar Interbody Fusion (PLIF) and Transforaminal Lumbar Interbody Fusion (TLIF) create intervertebral fusion by means of a posterior approach. Successful results have been reported with allograft, various cages (for interbody support), autograft and recombinant human bone morphogenetic protein‐2. Interbody fusion techniques facilitate reduction and enhance fusion. Corticocancellous laminectomy bone chips alone can be used as a means of spinal fusion in patients with single level instrumented PLIF. This has got a good fusion rate. PLIF with cage gives better fusion on radiology than PLIF with iliac bone graft, but no statistical difference in the clinical outcome. Cage use precludes complications associated with iliac bone harvesting. The reported adjacent segment degeneration was 40.5% and reoperation was 8.1% after 10 years of follow up. MATERIALS AND METHODS 30 cases of spondylolisthesis who attended the Orthopaedic Outpatient Department of Andhra Medical College, Visakhapatnam, from 2014 to 2016 were taken up for study. All the cases were examined clinically and confirmed radiologically. The patient’s age, sex, symptoms and duration were noted and were examined clinically for the status of the spine. Straight leg raising test was done and neurological examination of the lower limbs performed. All the patients were subjected to the radiological examination of the lumbosacral spine by taking anteroposterior, lateral (flexion and extension views), oblique views to demonstrate spondylolysis and spondylolisthesis. MRI and x-rays studies were done in all the cases to facilitate evaluation of the root compression disk changes and spinal cord changes. RESULTS In our study, we followed all the 30 patients after the surgery following procedure of removal of loose lamina, spinous process and fibrocartilaginous mass, PLIF with only the laminectomy bone mass and CD screw system fixation up to 2 years. 12 patients (40%) had excellent results, 15 patients (50%) had good and 3 patients (10%) had fair results. CONCLUSION We conclude that our procedure has fared equally effective when compared with short-term results of cage with PLIF and iliac crest bone grafting technique with respect to achievement of fusion at the intended intervertebral space. This procedure eliminates the cost of cage and substantially reduces the financial burden on the patient, which makes the procedure amicable in rural areas.
Authors and Affiliations
Pardhasaradhi M, Kishore Babu S, Manikumar C. J
Keywords
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- EP ID EP267449
- DOI 10.18410/jebmh/2017/787
- Views 65
- Downloads 0
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