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Instrumented Posterior Lumbar Interbody Fusion in Adult Spondylolisthesis

  • Original Article
  • Published:
Clinical Orthopaedics and Related Research

Abstract

It is unclear whether using artificial cages increases fusion rates compared with use of bone chips alone in posterior lumbar interbody fusion for patients with lumbar spondylolisthesis. We hypothesized artificial cages for posterior lumbar interbody fusion would provide better clinical and radiographic outcomes than bone chips alone. We assumed solid fusion would provide good clinical outcomes. We clinically and radiographically followed 34 patients with spondylolisthesis having posterior lumbar interbody fusion with mixed autogenous and allogeneic bone chips alone and 42 patients having posterior lumbar interbody fusion with implantation of artificial cages packed with morselized bone graft. Patients with the artificial cage had better functional improvement in the Oswestry disability index than those with bone chips alone, whereas pain score, patient satisfaction, and fusion rate were similar in the two groups. Postoperative disc height ratio, slip ratio, and segmental lordosis all decreased at final followup in the patients with bone chips alone but remained unchanged in the artificial cage group. The functional outcome correlated with radiographic fusion status. We conclude artificial cages provide better functional outcomes and radiographic improvement than bone chips alone in posterior lumbar interbody fusion for lumbar spondylolisthesis, although both techniques achieved comparable fusion rates.

Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Mrs.Yen for help with collecting the patient data, Dr. Tsai and Dr. Hsu for help in assessing the fusion status, and anonymous reviewers for their valuable comments.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Tao-Yuan General Hospital, Taoyuan, Taiwan

    Ching-Hsiao Yu MD

  2. Department of Orthopaedic Surgery, National Taiwan University Hospital, No. 7, Chung Shan South Road, Taipei, 100, Taiwan

    Chen-Ti Wang MD, PhD & Po-Quang Chen MD, PhD

  3. Min-Sheng General Hospital, Taoyuan, Taiwan

    Po-Quang Chen MD, PhD

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  1. Ching-Hsiao Yu MD
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  2. Chen-Ti Wang MD, PhD
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  3. Po-Quang Chen MD, PhD
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Correspondence to Po-Quang Chen MD, PhD.

Additional information

One or more of the authors have received funding from NSC Grant NSC-2622 B 002-002 (PQC) and the Taiwan Spine Research Foundation (PQC).

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Yu, CH., Wang, CT. & Chen, PQ. Instrumented Posterior Lumbar Interbody Fusion in Adult Spondylolisthesis. Clin Orthop Relat Res 466, 3034–3043 (2008). https://doi.org/10.1007/s11999-008-0511-1

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  • DOI: https://doi.org/10.1007/s11999-008-0511-1

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