Long-Term Functional Outcome of Pedicle Screw Instrumentation as a Support for Posterolateral Spinal Fusion

Abstract

The long-term functional outcome of posterolateral spinal fusion improved significantly for boththose with and without pedicle screw instrumentation, with a global 70% satisfaction reported by the patients. Patients with isthmic spondylolisthesis Grades 1 and 2 with noninstrumented fusion had superior long-term outcomes after posterolateral spinal fusion in comparison with an instrumented fusion. In contrast, patients diagnosed as having primary degenerative instability improved significantly when the posterolateral fusion was supported by instrumentation. In actuality, pedicle screw instrumentation increased reoperation rate compared with noninstrumented posterolateral fusion.

Costs and effects in lumbar spinal fusion. A follow-up study in 136 consecutive patients with chronic low back pain

“…The aims of this study were (1) to establish an activitybased method for costing at the patient-level, (2) to investigate the correlation between costs and effects, (3) to investigate the influence of selected patient characteristics on cost-effectiveness and, (4) to investigate the incremental cost-effectiveness ratio of (a) posterior instrumentation and (b) intervertebral anterior support in lumbar spinal fusion. We hypothesized a positive correlation between costs and effects, that determinants of effects would also determine costeffectiveness, and that posterolateral instrumentation and anterior intervertebral support are cost-effective adjuncts in posterolateral lumbar fusion.…”

Role of ‘low cost Indian implants’ in our practice: our experience with 1,572 pedicle screws

“…In the Indian implant group, 87.5% had an excellent or good functional outcome, whereas in the foreign implant group, 87.4% had excellent or good functional outcome. Even in literature, the use of implants has not shown a positive correlation with the clinical outcome of the patient [13,14]. A limitation of our study is that differences in design (screw diameter, rod diameter, etc.)…”

A modified technique for the treatment of isthmic spondylolisthesis

“…Many authors have developed a number of surgical techniques to gain stability by fusion of the spondylolisthetic deformity. These include posterolateral intertransverse process fusion, ALIF, PLIF, TLIF or ELIF, transsacral cage fusion, presacral lumbar interbody fusion and combined anterior and posterior fusion (2,3,10,11,13,26,27,28).…”