The Results of Posterior Lumbar Inter-body Fusion using PEEK Cage andPedicle Screw Stabilization in Degenerative Lumbar Spinal Disorders / 대한정형외과학회잡지

ABSTRACT

PURPOSE: To evaluate the results of posterior lumbar interbody fusion (PLIF) using PEEK cage with local laminectomized bone and pedicle screws stabilization in multiple segment degenerative lumbar spinal disorders. MATERIALS AND METHODS: We performed a retrospective analysis (1 yr follow-up examination) on 152 patients with PLIF using PEEK cage. The 152 patients, were sub-categorized as follows 1) group A - one level fusion (80 cases), 2) group B - two level fusion (60 cases), and 3) group C - three level fusion (12 cases). We compared each group based on operation time, amount of bleeding, number of complications, sagittal alignment, fusion rate, adjacent segment problems, and evaluation of the clinical result as per the criteria in Kim et al (1991). RESULTS: For operation time group A took 190.25+/-40.89 min, group B took 230.46+/-39.13 min, and group C took 243.25+/-39.13 min (p=0.08). Furthermore, amount of bleeding for group A was 1,140+/-704 ml, group B was 1,328+/-776 ml, and group C was 1,688+/-756 ml (p=0.07). Consequently, no significant difference was observed between each group. For lumbar lordosis, segmental lordosis, anterior and middle disc height, the last follow-up value was significantly greater than the preoperative value in all three groups. For the adjacent segmental problem, group A had 6 cases, group B had 6 cases, and group C had 2cases. The clinical result revealed a good result in 93.25% for group A, 91.67% for group B, 91.67% for group C. In addition, the fusion rate was 93.75% for group A, 95.00% for group B, and 91.67% for group C. Moreover, the number post-operative complication cases for group A totaled 2 postoperative infections with metal loosening, 5 non-union, and 2 hematomas. Group B had 1 postoperative infection with metal loosening, 3 nonunion, 1 dural tear, and 1 incomplete root injury. Lastly, in group C, 1 complete root injury occurred. CONCLUSION: A PLIF using PEEK cage with local laminectomized bone and posterior pedicle screw stabilization in multiple segments should be considered to be a useful surgical method as a result of favorable clinical results and a fusion rate similar to the rate of a single segment.