The Comparison between Posterolateral Fusion and
Posterior Lumbar Interbody Fusion in Unstable Degenerative Spondylolisthesis |
퇴행성 척추전방전위증에서 후측방 유합술과 후방추체간 유합술의 비교 |
강철형; 김동후; 조철현 |
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Abstract |
We conducted a retrospective study to compare posterolateral fusion (PLF) with posterior lumbar
interbody fusion (PLIF) for the treatment of degenerative spondylolisthesis (DS) with segmental
instability. Forty patients who underwent a single level decompression and instrumented fusion
for DS with segmental instability were studied after a minimum follow up of 2 years. According to
the fusion methods; the patients were divided into two groups. We evaluated the clinical results
according to the ODI (Oswestry Disability Index); VAS and radiographic results.
The clinical outcomes on the ODI (VAS) scores were improved from 66.48% (7.52) to 38%
(2.24) for PLF group; from 68.07% (8.53) to 35%; (3.73) for PLIF group while the fusion rates
were 88% and 93% respectively. The mean slip angle was decreased from 3.57°to 1.84°for PLF
group; from 6.72°to 4.35°for PLIF group respectively. We found no statistical difference
between two groups with respect to clinical outcomes or improvement in the slip angle. Statistical
difference was only noted in the mean disc height increments. Disc height restoration was 1.24
mm and 4.04 mm respectively for PLF and PLIF groups (p= 0.001). PLF & PLIF both provided
successful clinical outcome in the DS with segmental instability; but PLIF provides a better
radiologic outcome in disc height restoration and fusion rate. We suggest that PLIF is better surgical option in the treatment of DS with segmental instability |
Key Words:
Degenerative spondylolisthesis, Lumbar, Posterior lumbar interbody fusion,
Posterolateral fusion, Segmental instability |
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