Posterior lumbar interbody fusion using local facet joint autograft and pedicle screw fixation.
METHODS
This is a retrospective study of 42 patients having lumbar degenerative disease or spondylolytic spondylolisthesis treated by posterior lumbar interbody fusion (PLIF) using local autogenous facet joint graft and pedicle screw fixation with an average follow-up time of 8.5 years.


OBJECTIVE
To evaluate the radiographic and clinical results of patients treated with PLIF using adjacent facet joint autograft and pedicle screw internal fixation.


BACKGROUND
Some goals of spinal surgery have been achieved by interbody arthrodesis using a posterior approach popularized by Cloward. However, significant problems including bone graft collapse, resorption, nonunion, persistent neurologic compression, and iliac crest donor complication using the classic PLIF remain. There are few reports describing the results of a PLIF by total facet joint excision.


METHODS
Forty-two patients (average, 53.2 years) treated at our institution with PLIF by total facetectomy were followed for an average period of 8.5 years. The changes in the Japanese Orthopedic Association score, the recovery rate, complications, and radiographic findings were evaluated.


RESULTS
Good radiographic fusion (92.9%) and clinical results (postoperative recovery rate of 76% in the Japanese Orthopedic Association score) were achieved by PLIF using local facet joint autograft and pedicle screw fixation in treating patients with debilitating lumbar degenerative disease. The complications related to the operative procedure occurred in three patients of delayed union.


CONCLUSIONS
For lumbar degenerative diseases with osteophytic changes of facet joints, PLIF using pedicle screw fixation and local autogenous bones obtained from facet excision may be justified as a treatment opinion. The procedure as described offers advantages for spinal surgery when PLIF is warranted.
Kai
Yukihiro
Y
Seimeikai Moro-oka Orthopaedic Hospital, Chikushi-gun, Fukuoka, Japan. Morookahpykai@aol.com
Oyama
Masanobu
M
Morooka
Masaaki
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000601:surgery; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013168:Spondylolisthesis / Q000209:etiology / Q000601:surgery; D013169:Spondylolysis / Q000150:complications; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000601:surgery*