Posterior Lumbar Interbody Fusion (PLIF) for Lumbar Degenerative Spondylolisthesis
This section presents the clinical outcomes (results) of patients of Dr Sears following decompression and fusion for spinal stenosis, associated with an unstable degenerative spondylolisthesis and no adjacent level pathology, in previously un-operated patients at the L4/5 level (single level only). The technique used in all patients was Posterior Lumbar Interbody Fusion (PLIF). An open rather than Minimally Invasive approach was used.
Most patients with a degenerative spondylolisthesis undergo surgery to relieve pain caused by nerve root compression (usually due to spinal canal stenosis), associated with the spondylolisthesis. The nerve root compression is relieved by a decompressive laminectomy that is done in addition to the fusion.
Not all patients with spinal canal stenosis and a degenerative spondylolisthesis, who undergo surgical nerve root decompression (laminectomy), also require an additional realignment, stabilisation and fusion procedure. When necessary, the fusion component of the surgery is done to address significant vertebral instability that would likely otherwise result in further deformity with pain or other symptoms of recurrent stenosis.
Included in the results section below are the operative complications and the prevalence of further surgery for Adjacent Segment Disease (i.e. the number of patients who had to undergo further surgery for symptoms arising from degeneration that subsequently developed at a level adjacent to the original fusion surgery) in 228 consecutive patients.
Data last updated: July 20th, 2022
Most patients with a degenerative spondylolisthesis undergo surgery to relieve pain caused by nerve root compression (usually due to spinal canal stenosis), associated with the spondylolisthesis. The nerve root compression is relieved by a decompressive laminectomy that is done in addition to the fusion.
Not all patients with spinal canal stenosis and a degenerative spondylolisthesis, who undergo surgical nerve root decompression (laminectomy), also require an additional realignment, stabilisation and fusion procedure. When necessary, the fusion component of the surgery is done to address significant vertebral instability that would likely otherwise result in further deformity with pain or other symptoms of recurrent stenosis.
Included in the results section below are the operative complications and the prevalence of further surgery for Adjacent Segment Disease (i.e. the number of patients who had to undergo further surgery for symptoms arising from degeneration that subsequently developed at a level adjacent to the original fusion surgery) in 228 consecutive patients.
Data last updated: July 20th, 2022
Number of patients/procedures with pre-op clinical outcome data: 213
Number (%age) of patients with pre-op & follow-up outcome data: 206 (97%)
Age of patients
Average: 69.1 years
Median: 70.3 years
Range: 33.1 - 89.4 years
Patient satisfaction (at last follow-up):
Number (%age) of patients with pre-op & follow-up outcome data: 206 (97%)
- 6+ months follow-up 202 (94.8%)
- 12+ months follow-up 193 (90.6%)
- 24+ months follow-up 175 (82.2%)
Age of patients
Average: 69.1 years
Median: 70.3 years
Range: 33.1 - 89.4 years
Patient satisfaction (at last follow-up):
- "Was the operation worthwhile?"
- Yes 95%
- No 4%
- Uncertain 1%
- "Under similar circumstances, would you have it again?"
- Yes 89%
- No 9%
- Uncertain 2%
|
Last follow-up1.5 / 10 1.9 / 10 2.6 / 10 0.8 / 10 1.1 / 10 1.4 / 10 19.0 41.0 52.2 |
Complications:
Intra-operative
Post-operative
Further Surgery for Adjacent Segment Degeneration
Intra-operative
- Nerve root injury: 1/228 (0.4%)
- Dural tear: 8/228 (3.5%)
Post-operative
- Deep wound infection: 1/228 (0.4%)
- Return to operating room for revision of pedicle screw placement: 2/228 (0.8%)
- Return to operating room for evacuation of epidural haematoma: 1/228 (0.4%)
Further Surgery for Adjacent Segment Degeneration
- Re-operation at adjacent level for n:ew problem (ASD): 28/228 (12.5%)
- Average time to recurrence: 70.3 months
- Median time to recurrence (range): 64 months (6.1 - 170)
