title: Clinical outcome in monosegmental fusion of degenerative lumbar instabilities:instrumented versus non-instrumented.
abstract: BACKGROUND
  Degenerative lumbar instabilities are one of the major reasons for low back pain, especially in elderly people. There is still controversy in the literature about the clinical outcome of instrumented monosegmental fusions compared to noninstrumented posterolateral fusions.
  
  
  METHODS
  In this study we described the postoperative outcome of 33 patients who underwent posterolateral monosegmental spinal fusion:instrumented (17 patients)or noninstrumented (16 patients).All patients received the same instrumentation system. Medical history (considering daily activities,sports,social contacts and quality of life),clinical examination and radiological analysis served as evaluation parameters. Data were collected by a questionnaire based on the Oswestry Disability Score for low back pain.
  
  
  RESULTS
  86.6%of all subjects showed an improvement of postoperative health status. Although patients with fusion without internal fixation needed a reduced dose of postoperative analgesics compared to the monosegmental non-instrumented group,there were no statistical differences in patient-reported,clinical and radiographical outcome between the two groups.
  
  
  CONCLUSIONS
  The results do not indicate a benefit in outcome from added instrumentation in elective lumbar fusions. This should be considered in each single case when a spinal fusion in the treatment of degenerative lumbar instability is indicated.
authors.affiliation: Department of Orthopedics, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Jäger
authors.forename: Konrad
authors.initials: K
authors.lastname: Seller
authors.forename: Peter
authors.initials: P
authors.lastname: Raab
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Krauspe
authors.forename: Alexander
authors.initials: A
authors.lastname: Wild
mesh_terms: D000328:Adult; D006801:Humans; D016268:Internal Fixators; D017116:Low Back Pain / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery*; D008161:Lumbosacral Region; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome