Two-level posterior lumbar interbody fusion for degenerative disc disease: improved clinical outcome with restoration of lumbar lordosis

Spine J. Nov-Dec 2005;5(6):600-7. doi: 10.1016/j.spinee.2005.04.001.


Background context: Although posterior lumbar interbody fusion (PLIF) for degenerative lumbar diseases is routine, there are few reports on double-level PLIF.

Purpose: To evaluate the clinical outcomes of double-level PLIF.

Study design/setting: A retrospective study of operated cases in Gifu, Japan.

Patient sample: Nineteen patients (8 men and 11 women, 59.5+/-10.2 years) who underwent double-level PLIF between 1996 and 2001.

Outcome measures: Operation time, blood loss, complications, the Japanese Orthopaedic Association (JOA) score for back pain and lumbar sagittal alignment were evaluated.

Methods: Patients were examined retrospectively at follow-ups of 3.6+/-1.7 years. Primary diseases were spondylolisthesis, spinal canal stenosis, degenerative scoliosis and herniated intervertebral disc. Fusion areas were L3 to L5 in 15 cases and L4 to S1 in 4 cases.

Results: The mean JOA score increased from an initial score of 12.9+/-3.5 to 21.3+/-4.9 at the final follow-up. There was a positive correlation (R=0.718, p<.001) between the increase in lordotic angle and the increase in the JOA score. Several parameters suggested that the surgical invasiveness was not minimal.

Conclusion: Double-level PLIF provided satisfactory results and preserved lumbar spine lordosis.

MeSH terms

  • Adult
  • Aged
  • Back Pain / diagnosis*
  • Back Pain / etiology
  • Back Pain / prevention & control*
  • Female
  • Humans
  • Intervertebral Disc Displacement / complications
  • Intervertebral Disc Displacement / diagnosis*
  • Intervertebral Disc Displacement / surgery*
  • Lordosis / diagnosis*
  • Lordosis / etiology
  • Lordosis / prevention & control
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Pain Measurement
  • Recovery of Function
  • Retrospective Studies
  • Spinal Fusion / instrumentation
  • Spinal Fusion / methods*
  • Treatment Outcome