Evaluation of Functional Outcomes in Individuals 10 Years after Posterior Lumbar Interbody Fusion with Corundum Implants and Decompression: A Comparison of 2 Surgical Techniques

Abstract

BackgroundThe purpose of this study was to evaluate lumbar spine-related functional disability in individuals 10 years after lumbar decompression and lumbar decompression with posterior lumbar interbody fusion (PLIF) with corundum implants surgery for degenerative stenosis and to compare the long-term outcome of these 2 surgical techniques.Material/MethodsFrom 1998 to 2002, 100 patients with single-level lumbar stenosis were surgically treated. The patients were randomly divided into 2 groups that did not differ in terms of clinical or neurological symptoms. Group A consisted of 50 patients who were treated with PLIF and the use of porous ceramic corundum implants; the mean age was 57.74 and BMI was 27.34. Group B consisted of 50 patients treated with decompression by fenestration; mean age was 51.28 and the mean BMI was 28.84.ResultsThere was no statistical significance regarding age, BMI, and sex. Both treatments revealed significant improvements. In group A, ODI decreased from 41.01% to 14.3% at 1 year and 16.3 at 10 years. In group B, ODI decreased from 63.8% to 18.36% at 1 year and 22.36% at 10 years. The difference between groups was statistically significant. There were no differences between the groups regarding the Rolland-Morris disability questionnaire and VAS at 1 and 10 years after surgery.ConclusionsLong-term results evaluated according to the ODI, the Rolland-Morris disability questionnaire, and the VAS showed that the both methods significantly reduce patient disability, and this was maintained during next 10 years. The less invasive fenestration procedure was only slightly less favorable than surgical treatment of stenosis by both PLIF with corundum implants and decompression.

Comparing Investigation Between Bilateral Partial Laminectomy and Posterior Lumbar Interbody Fusion for Mild Degenerative Spondylolisthesis

“…Several reports compared surgical outcomes between decompression surgery alone and decompression with lumbar spinal arthrodesis. 5,[16][17][18][19][20][21][22] Nevertheless, in many of these studies, the participants were patients who had lumbar spinal stenosis both with and without degenerative spondylolisthesis or those who underwent both PLF and PLIF in the spinal arthrodesis group, and no sufficient studies target only PLIF as spinal arthrodesis, although reportedly, in a recent meta-analysis, PLIF is determined to be an optimal treatment for lumbar spondylolisthesis compared with PLF. 23 A combination of disease and procedures leads to confounding factors when comparing surgical outcomes.…”

“…Several authors recommend fusion surgeries such as PLIF in patients with severe intervertebral instability or destruction of facet joint,7,8 but the appropriate surgical procedure to adopt for patients with mild slippage has not been supported. Several reports compared surgical outcomes between decompression surgery alone and decompression with lumbar spinal arthrodesis 5,16–22. Nevertheless, in many of these studies, the participants were patients who had lumbar spinal stenosis both with and without degenerative spondylolisthesis or those who underwent both PLF and PLIF in the spinal arthrodesis group, and no sufficient studies target only PLIF as spinal arthrodesis, although reportedly, in a recent meta-analysis, PLIF is determined to be an optimal treatment for lumbar spondylolisthesis compared with PLF 23.…”