Two-level posterior lumbar interbody fusion for degenerative disc disease: improved clinical outcome with restoration of lumbar lordosis.
BACKGROUND
Although posterior lumbar interbody fusion (PLIF) for degenerative lumbar diseases is routine, there are few reports on double-level PLIF.


OBJECTIVE
To evaluate the clinical outcomes of double-level PLIF.


METHODS
A retrospective study of operated cases in Gifu, Japan.


METHODS
Nineteen patients (8 men and 11 women, 59.5+/-10.2 years) who underwent double-level PLIF between 1996 and 2001.


METHODS
Operation time, blood loss, complications, the Japanese Orthopaedic Association (JOA) score for back pain and lumbar sagittal alignment were evaluated.


METHODS
Patients were examined retrospectively at follow-ups of 3.6+/-1.7 years. Primary diseases were spondylolisthesis, spinal canal stenosis, degenerative scoliosis and herniated intervertebral disc. Fusion areas were L3 to L5 in 15 cases and L4 to S1 in 4 cases.


RESULTS
The mean JOA score increased from an initial score of 12.9+/-3.5 to 21.3+/-4.9 at the final follow-up. There was a positive correlation (R=0.718, p<.001) between the increase in lordotic angle and the increase in the JOA score. Several parameters suggested that the surgical invasiveness was not minimal.


CONCLUSIONS
Double-level PLIF provided satisfactory results and preserved lumbar spine lordosis.
Hioki
Akira
A
Department of Orthopaedic Surgery, Gifu University School of Medicine, 1-1 Yanagido, Gifu City, 501-1194, Gifu, Japan.
Miyamoto
Kei
K
Kodama
Hirotaka
H
Hosoe
Hideo
H
Nishimoto
Hirofumi
H
Sakaeda
Hirofumi
H
Shimizu
Katsuji
K
D000328:Adult; D000368:Aged; D001416:Back Pain / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D008141:Lordosis / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D020127:Recovery of Function; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome