Clinical and Radiological Outcome of Unilateral Posterior Lumbar Interbody Fusion Using Cages

ABSTRACT

OBJECTIVE: The goal of study is the evaluation of clinicofunctional outcomes and fusion success rates of unilateral posterior lumbar interbody fusion(PLIF) using cages. METHODS: The authors conducted retrospective study of 81 patients who underwent unilateral PLIF using cages. The outpatient notes, standard hospital charts, and pre-and postoperative imaging studies were analyzed. In this study pre-and postoperative back pain, radiating pain, fusion success rates, pseudoarthrosis, clinicofunctional outcome, and complications were evaluated. Follow-up duration ranged from 3 to 8 years. RESULTS: Eighty-one patients underwent unilateral PLIF using 98 cages(TFC37, CH cage25, Novus cage 36). Two-level fusion was performed in 17 patients. There were 48 men(59%) and 33 women(41%). Seventh decade was most common(47%). The most common site of PLIF was at L4-5 space(69.4%) and left side(58%) was prevalent. Fusion was successful in 91 out of 98 levels(92.8%) and pseudoarthrosis was observed in five patients(7 level, 7%). The clinicofunctional results by Prolo scale were as followsgood(score 8-10)80.3%, moderate(score 6-7)14.8%, poor(score 5 or less 5)4.9%. Device migration was observed in six cases5(20%) of 25 CH cages and 1(2.8%) of 36 Novus cages. CONCLUSION: Unilateral PLIF using cage is one of method to decrease the rates of iatrogenic complications in patient of unilateral symptomatic spinal instability while preserving normal anatomic structures with good fusion success rates and clinicofunctional results after surgery.