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ORIGINAL ARTICLE
Year : 2013  |  Volume : 48  |  Issue : 3  |  Page : 241-248

Posterior lumbar interbody fusion with pedicular fixation for surgical treatment of failed back surgery syndrome


Department of Orthopaedic, Faculty of Medicine, Assiut University, Assiut, Egypt

Correspondence Address:
Khaled M. Hassen Ali
Department of Orthopaedic, Faculty of Medicine, Assiut University, Assiut
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-1148.125831

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Background Spine surgery can basically yield only two things: decompression of a nerve root and/or stabilization of painful joints. Failure to achieve both of them leads to continuation of back and/or leg pain because of persistence or recurrence of disc herniation and/or stenosis, infection, and fusion failure. Posterior lumbar interbody fusion (PLIF) has been considered the optimal solution for the above-mentioned problems. Aim of the work The aim of the work was to show the effectiveness and safety of PLIF surgery with pedicular fixation in the surgical treatment of failed back surgery syndrome (FBSS). Study design Prospective study. Patients and methods This study included 24 patients with FBSS treated with PLIF with pedicular fixation and an autogenous tricortical iliac bone graft. There were 14 men and 10 women, aged 30-62 years (average 46 years). Among the 24 patients, 10 had recurrent herniated disc with preoperative or intraoperative noticed spinal instability, eight had failed posterolateral fusion, and six had postoperative spondylodiscitis. Results The average Visual Analogue Scale of back pain improved significantly from 7.4 (range 6-9) preoperatively to 2.5 (range 1-5) at the last follow-up. The average Visual Analogue Scale of leg pain improved significantly from 6.1 (range 2-9) preoperatively to 2.8 (range 2-5) at the last follow-up. Finally, the average Oswestry Disability Index improved significantly from 78% (range 60-90%) preoperatively to 36.6% (range 32-48%) at the last follow-up. According to Brantigan evaluation, fusion was considered certain in 23 patients (95.8%) at the last follow-up. Conclusion The outcomes of PLIF with pedicular fixation in the surgical management of FBSS were encouraging in terms of significant improvement in back pain and leg pain, with good fusion rate and good quality of life.


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