Article
Re-operation rate after instrumented posterior lumbar interbody fusion. A report on 1680 cases
Reoperationsrate nach instrumentierter posterolumbaler intersomatischer Fusion. Ein Report über 1680 Fälle
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Published: | May 8, 2006 |
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Outline
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Objective: The use of different techniques demonstrates that there is currently no ideal procedure for lumbar fusion. The instrumented posterior lumbar interbody fusion (PLIF) shows a comparable success rate to the so called 360° fusion techniques (combined dorso-ventral spondylodesis) without the need of an anterior approach.
To answer the following questions: Re-operation rate after PLIF? And is there any influence of the length of fusion on the re-operation rate?
Methods: We reviewed 1680 patients, who underwent a PLIF at our institution between 1/1995 and 12/2000. 3053 levels were fused. The re-operation rate was analysed. The mean follow-up was 5 years.
Results: There were 221 (13.2%) re-operations in 206 patients (12.2%). Out of 1680 PLIF, 312 were multisegmental (>2 segments). Within this group 45 (14.4%) revisions were done. We found that the most important difference between the multisegmental PLIFs and the mono- or bisegmental PLIFs, is the rate of adjacent segment decompensation (5.1% compared to 2.3%) and this was statistically significant. The re-operation rate between those two groups was only slightly different with 12.9% for mono- or bisegmental and 14.4% for multisegmental PLIFs.
Conclusions: The fusion length does not show a significant difference on the re-operation rate as such. Nevertheless we registered a significant higher incidence for decompensation of adjacent segments after multisegmental PLIFs.