title: Clinical and radiological comparison of posterolateral fusion and posterior interbody fusion techniques for multilevel lumbar spinal stabilization in manual workers.
abstract: METHODS
  Eighty-four patients who had been treated for degenerative spinal diseases between January 2006 and June 2009 were reviewed retrospectively.
  
  
  OBJECTIVE
  We aimed to compare the clinical and radiologic findings of manual workers who underwent posterolateral fusion (PLF) or posterior interbody fusion (PLIF) involving fusion of 3 or more levels of the spine.
  
  
  BACKGROUND
  Previous studies have concluded that there is no significant difference between the clinical outcome of PLF and PLIF techniques.
  
  
  METHODS
  After standard decompression, 42 patients underwent PLF and the other 42 patients underwent PLIF. Radiologic findings, Oswestry disability index (ODI) scores, and visual analogue scale (VAS) scores were assessed preoperatively and at 6-month intervals postoperatively and return to work times/rates were assessed for 48 months.
  
  
  RESULTS
  Patients who underwent PLF had significantly shorter surgical time and less blood loss. According to the 48-month clinical results, ODI and VAS scores were reduced significantly in the two groups, but the PLIF group showed better results than the PLF group at the last follow-up. Return to work rate was 63% in the PLF group and 87% in the PLIF group. Union rates were found to be 81% and 89%, respectively, after 24 months (p=0.154).
  
  
  CONCLUSIONS
  PLIF is a preferable technique with respect to stability and correction, but the result does not depend on only the fusion rates. Discectomy and fusion mass localization should be considered for achieving clinical success with the fusion technique. Before performing PLIF, the association of the long operative time and high blood loss with mortality and morbidity should be taken into consideration, particularly in the elderly and disabled patients.
authors.affiliation: Depertment of Orthopaedics, Kafkas Univeristy Medical School, Kars, Turkey.
authors.forename: Hayati
authors.initials: H
authors.lastname: Aygün
authors.affiliation: Depertment of Orthopaedics, Kafkas Univeristy Medical School, Kars, Turkey.
authors.forename: Albert
authors.initials: A
authors.lastname: Cakar
authors.affiliation: Department of Neurology, Kafkas Univeristy Medical School, Kars, Turkey.
authors.forename: Nergiz
authors.initials: N
authors.lastname: Hüseyinoğlu
authors.affiliation: Department of Anesthesiology, Kafkas Univeristy Medical School, Turkey.
authors.forename: Urfettin
authors.initials: U
authors.lastname: Hüseyinoğlu
authors.affiliation: Department of Orthopaedics, Spatial Şifa Hospital, Erzurum, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Celik
keywords: Degenerative spine; Disc disease; Posterior interbody fusion; Posterolateral fusion; Scoliosis; Spinal instability