Efficacy of less invasive posterior lumbar interbody fusion as revision surgery for patients with recurrent symptoms after discectomy

J Bone Joint Surg Br. 2011 Nov;93(11):1518-23. doi: 10.1302/0301-620X.93B11.27187.

Abstract

Recurrence of back or leg pain after discectomy is a well-recognised problem with an incidence of up to 28%. Once conservative measures have failed, several surgical options are available and have been tried with varying degrees of success. In this study, 42 patients with recurrent symptoms after discectomy underwent less invasive posterior lumbar interbody fusion (LI-PLIF). Clinical outcome was measured using the Oswestry Disability Index (ODI), Short Form 36 (SF-36) questionnaires and visual analogue scales for back (VAS-BP) and leg pain (VAS-LP). There was a statistically significant improvement in all outcome measures (p < 0.001). The debate around which procedure is the most effective for these patients remains controversial. Our results show that LI-PLIF is as effective as any other surgical procedure. However, given that it is less invasive, we feel that it should be considered as the preferred option.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Disability Evaluation
  • Diskectomy*
  • Female
  • Humans
  • Low Back Pain / etiology
  • Low Back Pain / surgery*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Pain Measurement / methods
  • Prospective Studies
  • Radiography
  • Recurrence
  • Reoperation / methods
  • Spinal Fusion / adverse effects
  • Spinal Fusion / methods*
  • Treatment Outcome