title: Prospective Study of Posterior Lumbar Interbody Fusion With Either Interbody Graft or Interbody Cage in the Treatment of Degenerative Spondylolisthesis.
abstract: METHODS
  A prospective study of 2 different fusion techniques for the treatment of single-level degenerative spondylolisthesis.
  
  
  OBJECTIVE
  To determine whether the addition of an intervertebral cage improves the clinical outcome and fusion rate of patients undergoing posterior lumbar interbody fusion (PLIF) after decompression for degenerative spondylolisthesis.
  
  
  BACKGROUND
  The surgical approach that should be used for degenerative spondylolisthesis is a controversial issue. Decompression and PLIF with an interbody cage is widely used. Theoretical advantages in favor of PLIF include anterior column support, indirect foraminal decompression, restoration of lordosis, and reduction of the slip via ligamentotaxis. Despite numerous publications, the scientific support for the PLIF method is, however, weak.
  
  
  METHODS
  A prospective study was carried out including 59 patients with degenerative spondylolisthesis. Average age of patients was 66 years: 34 males and 25 females. Patients were divided into 2 treatment groups: group 1-32 patients with PLIF with interbody graft and group 2-27 patients with PLIF with cage. Minimum 2-year follow-up. Outcomes were assessed by measuring preoperative and postoperative lordotic angles. SF-12 physical and mental health scores were recorded along with visual analogue scores for pain. Complications were also recorded.
  
  
  RESULTS
  No significant difference in the postoperative lordotic angles was achieved between the 2 techniques. Nonsignificant difference in the clinical outcomes between both the techniques.
  
  
  CONCLUSIONS
  We have found the use of a cage to achieve lumbar interbody fusion in the treatment of degenerative lumbar spondylolisthesis does not confer any significant advantages in terms of restoration of lumbar lordosis, improvement in clinical symptoms, or relief of pain postoperatively.
authors.affiliation: *Royal London Hospital, Whitechapel †Royal National Orthopaedic Hospital, Stanmore, London ‡Norfolk and Norwich University Hospital, Norwich, UK.
authors.forename: A
authors.initials: A
authors.lastname: Sivaraman
authors.forename: Farhaan
authors.initials: F
authors.lastname: Altaf
authors.forename: Azal
authors.initials: A
authors.lastname: Jalgaonkar
authors.forename: Rahul
authors.initials: R
authors.lastname: Kakkar
authors.forename: P B R
authors.initials: PB
authors.lastname: Sirigiri
authors.forename: A
authors.initials: A
authors.lastname: Howieson
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Crawford
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008141:Lordosis / Q000000981:diagnostic imaging / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D011446:Prospective Studies; D011859:Radiography; D013123:Spinal Fusion / Q000379:methods*; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000601:surgery*; D011795:Surveys and Questionnaires