[Experience in reoperation of lumbar spinal surgery using posterior lumbar interbody fusion cage].
OBJECTIVE
To investigate the indications and surgical techniques of reoperative lumbar spinal surgery using posterior lumbar interbody fusion cage.


METHODS
Seventeen cases underwent reoperative lumbar spinal surgery using posterior lumbar interbody fusion cage. The surgical methods included decompression of lumbar canal, dural and radicular conglutination release, discectomy, posterior insertion of lumbar interbody fusion cage, pedicle screw instrumentation, posterolateral lumbar fusion. Periodical follow-up was conducted for 18 months (12 - 43 months). The clinical effect was evaluated by the Macnab's criterion, and the outcome of lumbar interbody fusion was evaluated according to the Brantigan's criterion.


RESULTS
Twenty-seven cages were implanted into twenty-three disc spaces (cage at L(3 - 4) in 5 cases, cage at L(4 - 5) in 8 cases, and cage at L(5)-S(1) in 4 cases). All postoperative patients ambulated after two weeks. No wound healing problems and nerve injury were found. Dural rupture occurred in 5 cases, but without occurrence of cerebrospinal fluid leakage. According to the Macnab's criterion, the preoperative lower extremity radicular symptoms and neurogenic claudication were effectively relieved in 15 cases (88.2%), and the outcomes were good or excellent in 15 cases (88.2%). According to the Brantigan's criterion no evidence of implant failure was found, and interbody fusion could be achieved about 6 months in all patients. No additional operation was needed for involved segments, and the surgical outcomes could be maintained.


CONCLUSIONS
A good and effective method, use of posterior lumbar interbody fusion cage in reoperative lumbar spinal surgery eliminates neural compression and the discogenic pain, restore the lumbar alignment, and accomplish the internal fixation and anterior column fusion of lumbar vertebrae simultaneously.
Wang
Hui-min
HM
Department of Spinal Surrey, People's Hospital, Peking University, Beijing 100044, China.
Liu
Hai-ying
HY
Wang
Bo
B
Zhang
Jian
J
Miao
Ke-nan
KN
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012086:Reoperation / Q000379:methods*; D013123:Spinal Fusion / Q000295:instrumentation