The Bagby and Kuslich method of lumbar interbody fusion. History, techniques, and 2-year follow-up results of a United States prospective, multicenter trial.
METHODS
A prospective, multicenter trial of the Bagby and Kuslich method of lumbar interbody stabilization for chronic discogenic low back pain, with follow-up evaluation at 3 months, 6 months, and yearly thereafter, with independent radiographic analysis.


OBJECTIVE
To report the history of development, the surgical techniques, and results of the Bagby and Kuslich method when used to manage discogenic pain of the lumbar spine in humans.


BACKGROUND
Disabling chronic low back pain frequently is resistant to conservative management. The "Bagby Basket" effectively has fused the equine and baboon spine. The results of biomechanical and animal studies performed over the last 20 years have suggested that a similar but improved design--the Bagby and Kuslich device--would be useful in stabilizing the human spine.


METHODS
From 1992 to 1995, 947 patients with chronic discogenic low back pain were treated by Bagby and Kuslich interbody fusion in a strict, multicenter, prospective clinical trial by using either the open anterior or open posterior approach. The study involved 42 surgeons at 19 medical centers. The authors of the current report analyzed the fusion rates, pain relief, functional status, and complications occurring in patients who underwent long-term follow-up observation.


RESULTS
The Bagby and Kuslich method is safe and effective when compared with methods described in previous reports of posterior and anterior lumbar interbody arthrodesis performed by using bone graft alone. Fusion occurred in 91% of patients at 24 months after surgery, and pain was eliminated or reduced in 84%. Function was improved in 91%. There were no device-related deaths, cases of major paralyses, device failures, or deep infections.


CONCLUSIONS
Carefully selected middle-aged patients with chronic low back pain secondary to degenerative disc disease can be treated effectively and safely by skilled surgeons using the Bagby and Kuslich device for one- and two-level interbody fusion.
Kuslich
S D
SD
Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, USA.
Ulstrom
C L
CL
Griffith
S L
SL
Ahern
J W
JW
Dowdle
J D
JD
D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000379:methods; D002908:Chronic Disease; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D049673:History, 20th Century; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D019736:Prostheses and Implants; D011859:Radiography; D013122:Spinal Diseases / Q000150:complications; D013123:Spinal Fusion / Q000266:history / Q000379:methods*; D014481:United States