Evaluation of the clinico-radiological outcome of lumbar interbody fusion using cage and local bone graft in management of lumbar spondylolisthesis

Abstract

Background: Pain in the lower lumbar spine is a socioeconomically serious medical illness. The main reason from physiological perspective was micro and macro instability of spine. Posterior lumbar interbody fusion (PLIF) is a reliable treatment option for patients with spondylolisthesis; providing spinal stabilization in a balanced alignment with the disc space height being restored and with the neural elements being decompressed mechanically. Aims: To study clinical and radiological outcomes of Posterior lumbar interbody fusion with cage and local bone graft from laminectomy bone chips in lumbar spondylolisthesis. Material and Method: Our study includes 4 males and 8 females, aging 35-64 years. As per the Meyerding-evaluating system, 11 cases were classified as degree I, 1 cases as degree II, and 0 cases as degree III. The average follow-up duration was 18 months. The clinical outcomes were evaluated using the Oswestry Disability Index preoperatively and at 4th, 8th 12th, 18th month and the Kim & Kim criteria at last follow up. The radiological outcomes were evaluated as per the Modified Lee's criteria for fusion. Results: There were 7 cases of definitive fusion, 4 cases of probable fusion and 1 case of pseudoarthrosis, with a fusion rate of 91.67% (definitive 58.3 % + probable 33.3 %). The mean time for fusion was 16 months. There were no implant failures. According to Kim & Kim clinical criteria for scoring, the results were excellent in 9 cases, good in 2 cases, and fair in 1 case. The excellent and good rate was 91.66 %. Conclusion: PLIF with cage and bone graft from local laminectomy chips serves as a solid internal fixation and has the advantages of shorter operative time and less blood loss. This technique also provides excellent outcomes according to the clinical and radiological evaluation.

Comparative study between transpedicular screws fixation with and without interbody fusion using cages in lumbar spondylolisthesis

“…On the other hand, 45 % patients in group B achieved grade I and55% patients achieved grade III Rao et al 17 agree with our study as he found that the interbody fusion was advantageous for increasing the fusion rate and obtained early stability and high rate of fusion following PLIF with the use of pedicle screws for fixation than using posterior lateral screw fusion alone.…”