[Results of dorsal lumbosacral distraction spondylodesis without implant in previously surgically treated back patients].
Lumbosacral fusions of the L4/5 and L5/S1 segment were performed in 168 patients with a tricortical iliac crest bone graft between the spinal processes L4 and S1 and two posterolateral fusions (LSDS). At follow-up five or more years after surgery, 46 of 55 patients with prior back surgery had a solid bony fusion. Pain was reduced in 94% of the failed back patients; 61.8% were satisfied with the result. On a ten-point scale from no (0) up to unacceptable (10) pain, the degree of back-pain decreased five years after fusion from 9.1 to 4.9 points, while the leg pain was reduced from 8.5 to 4.3. During surgery and the early postoperative period four major complications occurred in 168 patients. Twice the dura was perforated and two graft luxations were seen. No deep wound infections and no nerve root lesions were seen after surgery. The average blood loss was substituted by 2.4 erythrocyte concentrates. The lumbosacral distraction spondylodesis is a fusion of the two lower lumbar segments with satisfactory clinical and radiological results and a low complication rate. In patients with a failed back syndrome the pain in most cases decreased. The fact that 38.2% of the patients are unsatisfied with the result is most likely due to the severe scar tissue following prior surgery.
Wittenberg
R H
RH
Aus der Orthopädischen Universitätsklinik im St. Josef-Hospital, Bochum.
Möller
J
J
Krämer
J
J
D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000379:methods; D002921:Cicatrix / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D012447:Sacrum / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*
Ergebnisse nach dorsaler lumbosakraler Distraktionsspondylodese (LSDS) ohne Implantat beim voroperierten Rückenpatienten.