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Título
Long-term outcomes of posterior lumbar interbody fusion using stand-alone ray threaded cage for degenerative disk disease: A 20-year follow-up
Año del Documento
2016
Editorial
Korean Society of Spine Surgery
Descripción
Producción Científica
Documento Fuente
Asian Spine Journal, 2016; vol. 10, n. 6. p. 1100-1105
Abstract
Study Design: Retrospective study.
Purpose: To analyze outcomes of posterior lumbar interbody fusion (PLIF) stand-alone cages.
Overview of Literature: PLIF for degenerative disk disease using stand-alone cages has lost its popularity owing to implant-related
complications and pseudoarthrosis.
Methods: We analyzed the records of 45 patients (18 women, 27 men), operated between January 1994 and December 1996, with
a mean follow-up of 18 years 3 months (20 years 3 months–22 years 3 months). Clinical outcomes were measured using visual
analogue score (VAS), Oswestry disability index (ODI), Odom’s criteria, and radiological measurements of fusion rate, Cobb angle, and
implant-related complications conducted at the preoperative evaluation, hospital discharge, 12-month follow-up, and final follow-up.
Results: Preoperative mean VAS (back) was 6.9 and VAS (radicular) was 7.2, with mean improvements (p<0.05) of 2.9 and 3.1,
respectively, at the final follow-up. Median preoperative ODI was 64.5, with a mean improvement to 34 and 42 at the 12-month and
final follow-ups, respectively (p<0.05). Odom’s criteria at the 12-month follow-up were excellent in 11.2% patients, good in 57.7%,
fair in 31.1%, and poor in none of the patients; at the final follow-up, no patient was classified as excellent, 71.1% as good, 22.2% as
fair, and 6.7% as poor (p<0.05). Pseudoarthrosis was observed in five patients (11.1%), of whom, three (6.6%) required re-operation.
Preoperative disk height was 9.23 mm, which increased to 13.33 mm in the immediate postoperative evaluation and was maintained
at 10.0 mm at the final follow-up (p<0.05). The preoperative mean L1–S1 Cobb angle was 34.7°, which changed to 44.7° in the immediate postoperative evaluation and dropped to 39.7° at the final follow-up (p<0.005).
Conclusions: PLIF stand-alone cages were associated with good clinical outcomes. Although the fusion rate was excellent, maintenance of disk heights and a lordotic alignment were not achieved in the long term.
Palabras Clave
Spinal fusion
Fusión espinal
Degenerative disk disease
Enfermedad degenerativa de disco
ISSN
1976-7846
Revisión por pares
SI
Version del Editor
Propietario de los Derechos
© 2016 Korean Society of Spine Surgery
Idioma
eng
Tipo de versión
info:eu-repo/semantics/publishedVersion
Derechos
openAccess
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