title: Clinical outcomes and considerations of the lumbar interbody fusion technique for lumbar disk disease in adolescents.
abstract: OBJECTIVE
  The posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) techniques are commonly used surgical methods for wide indications such as degeneration or trauma. Although they are rarely required for lumbar disk disease in younger patients, there are a few children and adolescents who are indicated for PLIF or TLIF for other reasons, such as congenital severe stenosis with or without lumbar instability that requires wide decompression or severe bony spur that need to be removed. In such cases, different pathophysiology and outcomes are expected compared with adult patients.
  
  
  METHODS
  We retrospectively reviewed data of 23 patients who underwent PLIF or TLIF surgery when less than 20 years old. Clinical and radiographic outcomes were assessed during a mean of 36.4 months follow-up period. The indications of lumbar interbody fusion, success of fusion, complications, and visual analog scale (VAS) were analyzed.
  
  
  RESULTS
  Radiographs of all patients taken 6 months after the surgery showed fusion. Clinical outcome was also satisfactory, with improvement of VAS score from 7.7 preoperatively to 2.3 at 6 months after surgery. Only one patient had reoperation due to adjacent segment disease.
  
  
  CONCLUSIONS
  For adolescent patients with severe bony spur, massive central disk rupture, or severe spondylolisthesis, lumbar interbody fusion surgery has good surgical outcome with few complications.
authors.affiliation: Department of Spinal Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University Collegeof Medicine, 712, Eonjuro, Gangnam-gu, Seoul, Republic of Korea.
authors.forename: Dae-Woong
authors.initials: DW
authors.lastname: Kwon
authors.forename: Kyung-Hyun
authors.initials: KH
authors.lastname: Kim
authors.forename: Jeong-Yoon
authors.initials: JY
authors.lastname: Park
authors.forename: Dong-Kyu
authors.initials: DK
authors.lastname: Chin
authors.forename: Keun-Su
authors.initials: KS
authors.lastname: Kim
authors.forename: Young-Eun
authors.initials: YE
authors.lastname: Cho
authors.forename: Sung-Uk
authors.initials: SU
authors.lastname: Kuh
mesh_terms: D000293:Adolescent; D002648:Child; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000473:pathology / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000473:pathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D010147:Pain Measurement; D011183:Postoperative Complications; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
references.citation: Neurosurg Clin N Am. 2007 Oct;18(4):659-67
references.pmid: 17991589
references.citation: Eur Spine J. 2011 Nov;20(11):1951-60
references.pmid: 21786038
references.citation: J Spinal Disord Tech. 2008 Apr;21(2):86-91
references.pmid: 18391710
references.citation: Spine (Phila Pa 1976). 2001 Mar 1;26(5):567-71
references.pmid: 11242386
references.citation: Spine (Phila Pa 1976). 1997 Sep 1;22(17):2001-4
references.pmid: 9306530
references.citation: Radiology. 1990 Dec;177(3):763-5
references.pmid: 2243985
references.citation: Adv Orthop. 2012;2012:282068
references.pmid: 22548181
references.citation: J Am Acad Orthop Surg. 2011 Nov;19(11):649-56
references.pmid: 22052641
references.citation: Eur Spine J. 2010 Feb;19(2):205-14
references.pmid: 19890666
references.citation: J Am Acad Orthop Surg. 2008 Mar;16(3):130-9
references.pmid: 18316711
references.citation: Singapore Med J. 2012 Mar;53(3):183-7
references.pmid: 22434292
references.citation: Clin Orthop Relat Res. 2005 Feb;(431):120-8
references.pmid: 15685064
references.citation: Spine J. 2010 Jun;10(6):530-43
references.pmid: 20381432
references.citation: Acta Paediatr. 2010 Jan;99(1):19-23
references.pmid: 19659503
references.citation: AJNR Am J Neuroradiol. 2005 Sep;26(8):2057-66
references.pmid: 16155160
references.citation: Clin Orthop Surg. 2011 Mar;3(1):39-47
references.pmid: 21369477
references.citation: J Bone Joint Surg Br. 2010 Jun;92(6):751-9
references.pmid: 20513868
references.citation: Eur Spine J. 2003 Aug;12(4):378-85
references.pmid: 12734742
references.citation: Acta Neurochir (Wien). 2011 Jul;153(7):1409-16; discussion 1416
references.pmid: 21573807
references.citation: Yonsei Med J. 2005 Feb 28;46(1):125-32
references.pmid: 15744815
references.citation: Spine (Phila Pa 1976). 2006 May 20;31(12):1351-7; discussion 1358
references.pmid: 16721298
references.citation: Childs Nerv Syst. 2007 Nov;23(11):1295-9
references.pmid: 17541606
references.citation: Spine (Phila Pa 1976). 2003 May 15;28(10):997-1001
references.pmid: 12768137
references.citation: Neuroradiology. 1994 Aug;36(6):453-5
references.pmid: 7991090
references.citation: Spine (Phila Pa 1976). 1987 Mar;12(2):97-104
references.pmid: 2954220
references.citation: Spine (Phila Pa 1976). 2006 Mar 1;31(5):583-90; discussion 591-2
references.pmid: 16508556