title: Posterolateral lumbar fusion. Outcome of 71 consecutive operations after 4 (2-7) years.
abstract: We report the outcome of 71 consecutive posterolateral lumbar fusions without spinal instrumentation. The indication for the operation was spondylolysis-olisthesis, degenerative disc disease/facet joint arthrosis, or pain after prior laminectomy. Concerning pain relief, 29/43 patients with spondylolysis-olisthesis were classified as good. The corresponding figures in the group with degenerative disc disease and/or facet joint arthrosis were 8/16 patients and in the group with pain post-laminectomy, 6/12 patients. No surgical complications were noted. In the total material 54 patients had a solid fusion, as defined by radiographic osseous trabecular bridging at all intended levels. One-level fusions tended to heal solidly in a higher frequency than two-level fusions. For the spondylolysis-olisthesis group, healed fusion correlated with a good clinical result. Such a correlation could not be verified for the other diagnostic groups. We conclude that non-instrumented posterolateral lumbar fusion is a valid method for treating low-grade spondylolysis-olisthesis, especially when the aim is to fuse a single level. Improved patient selection methods are required in fusion for degenerative disc disease and pain after laminectomy.
authors.affiliation: Department of Orthopedics, Lund University Hospital, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Axelsson
authors.forename: R
authors.initials: R
authors.lastname: Johnsson
authors.forename: B
authors.initials: B
authors.lastname: Strömqvist
authors.forename: M
authors.initials: M
authors.lastname: Arvidsson
authors.forename: K
authors.initials: K
authors.lastname: Herrlin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D002648:Child; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D011859:Radiography; D013122:Spinal Diseases / Q000601:surgery; D013123:Spinal Fusion / Q000009:adverse effects; D013169:Spondylolysis / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000700:Analgesics