Treatment of postdiscectomy low back pain by percutaneous posterior lumbar interbody fusion versus open posterior lumbar fusion with pedicle screws.
BACKGROUND
Up to a fifth of the patients who had discectomy undergo spinal fusion because of disabling low back pain.


OBJECTIVE
To compare the clinical outcome of percutaneous posterior lumbar interbody fusion (PPLIF) to that of open posterior lumbar fusion (PLF).


METHODS
Two surgical methods that were tried in sequence at a university affiliated hospital.


METHODS
Sixty patients with disabling postdiscectomy low back pain.


METHODS
Pain intensity was scored on a visual analog scale (VAS) and the degree of disability was scored by the Oswestry disability index (ODI).


METHODS
Thirty patients were treated by PPLIF. The outcome, after 24 months or more, was compared retrospectively with that of 30 consecutive suitable subjects who had been treated by PLF with pedicle screw fixation by the same surgeons for the same indication.


RESULTS
In the PPLIF group, as compared with PLF group, mean operating time was shorter, blood loss was negligible, and mean hospital time was halved. By the last follow-up visit (greater than or equal to 2 years), pain and disability in PLF group had diminished by 31.9% and 20.1%, respectively. The corresponding figures in PPLIF group were 55.4% and 42.7%, respectively.


CONCLUSIONS
In the context of postdiscectomy low back pain, PPLIF has proven, thus far, to be a safe procedure with improved clinical results.
Gepstein
Reuven
R
Sapir Medical Center, 57 Tchernichowski, Kfar-Saba 44281, Israel.
Shabat
Shay
S
Reichel
Michael
M
Pikarsky
Ilia
I
Folman
Yoram
Y
D000328:Adult; D001863:Bone Screws; D017586:Diskectomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*