Posterior Lumbar Interbody Fusion Using an Unilateral Cage: A Prospective Study of Clinical Outcome and Stability

Abstract

ObjectiveThe purpose of this study was to evaluate the clinical and radiological results of instrumented posterior lumbar interbody fusion (PLIF) using an unilateral cage.MethodsSeventeen patients with unilateral radiculopathy who underwent bilateral percutaneous screw fixation with a single fusion cage inserted on the symptomatic side for treatment of focal degenerative lumbar spine disease were prospectively enrolled in this study. Their clinical results, radiological parameters, and related complications were assessed 10 days, 3 months, and 12 months postoperatively.ResultsThere was no pseudarthrosis, instrumented fusion failure, significant cage subsidence, or retropulsion in any patient. The surgery restored the disc space height and maintained it as of 12 months postoperatively and did not exacerbate the lumbar lordotic and scoliotic angles. All patients had excellent or good outcomes according to the modified MacNab's criteria. The mean pain score according to the visual analogue scale was 7.5 preoperatively but had improved to 2.5 when reassessed 3 months postoperatively. The improvement was maintained as of 12 months postoperatively.ConclusionIn cases of uncomplicated unilateral radiculopathy, PLIF using a single cage can be an effective and safe procedure with the advantage of preserving the posterior elements of the contralateral side. A shorter operative time and greater cost-effectiveness than for PLIF using bilateral cages can be expected.

Instrumented posterior lumbar interbody fusion using a single cage and corticocancellous laminectomy bone chips for L4-L5 massive lumbar disc herniation with instability

“…In this study, the mean body mass index in our study is 26.14 + 1.95 kg/m 2 and is comparable to that of Jeon CH et al [19] study. The mean amount of blood loss is 300 ml and the amount of blood loss is comparable to other study by Lee SK et al [20] and Jin Z et al [21] . The mean operative time is 125 minute and it is comparable with other study by Lee SK et al [20] and Jin Z et al [21] .…”

“…The mean amount of blood loss is 300 ml and the amount of blood loss is comparable to other study by Lee SK et al [20] and Jin Z et al [21] . The mean operative time is 125 minute and it is comparable with other study by Lee SK et al [20] and Jin Z et al [21] . The mean hospitalization period is 11 days, and it is comparable with the other study by Jin Z et al [21] and Kim DH et al [22] .…”

“…Radiologically, the mean preoperative disc height at the involved segment was increasing from 6.77 + 0.58 mm, to 7.95 + 0.84 mm at immediate postoperative but dropped to 7.42 + 0.74 mm at 14 months follow up which is comparable to various study. In the study done by Lee SK et al [20] the preoperative disc height increases from 7.1+3 mm to 9.6+3 mm at immediate postoperative and 9.2+2.5 mm at last follow up. Kim DH et al [22] also found that the preoperative disc height increases from 9.2+2.68 mm to 13.62+1.35mm at immediate postoperative and decrease to 12.46+1.61mm at last follow up.…”