Journal List > J Korean Soc Spine Surg > v.12(1) > 1035692

Byun, Park, Kim, and Yoo: Posterior Lumbar Interbody Fusion Using Laminar Bone and Titanium Block

Abstract

Study Design

A retrospective study to analyze the results of posterior lumbar interbody fusion, using laminar bone and titanium block, with pedicle screw instrumentation.

Objectives

To evaluate the clinical and radiological results of posterior lumbar interbody fusion, using laminar bone and titanium block, with pedicle screw instrumentation.
Summary of literature review: Several studies have demonstrated the results of posterior lumbar interbody fusion, there has been no report on our method.

Materials and Methods

From March 2001 to May 2002, seventeen patients were treated by posterior lumbar interbody fusion, using laminar bone block, from spinous process and titanium block. All patients were clinically followed up over 12 months. The mean age of the patients and followup were 58 years and 15 months, respectively. The clinical results were evaluated by Kim’s criteria and radiological union, and the subsidence of disc space and change of the lordotic curve were assessed by a simple X-ray.

Results

The satisfactory clinical result and radiological union rates were 83.3 and 90.4%, respectively. The mean subsidence of the disc space and change of the lordotic curve were 0.8 mm and 1.6 degrees, respectively. There was one complication of a wrong insertion of the pedicle screw to the disc space.

Conclusion

Posterior lumbar interbody fusion using laminar bone and titanium block showed an acceptable radiological union rate and clinical results. This could be a good alternative method for obtaining initial stability and bony union without taking a bone graft from the posterior ilium in various spinal lesions.

REFERENCES

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Figures and Tables%

Fig. 1.
(A) Photograph showing titanium block (Prospace). (B) Photograph showing en bloc osteotomized lamina and spinous process with removal of soft tissue.
jkss-12-52f1.tif
Fig. 2.
A 55-year-old male patient with spondylolisthesis L4 on L5 (case 10). (A, B) Preoperative anteroposterior and lateral roentgenograms showing anterior slippage of L4. (C, D) Postoperative anteroposterior and lateral roentgenograms shows well fixed graft and titanium block with maintaining of intervertebral disc space and reduction of spondylolisthesis. (E, F) Roentgenograms at the final followup showing complete union without settlement. Clinically the patient achieved an excellent result.
jkss-12-52f2.tif
Table 1.
The results of PLIF using Laminar Bone Block and Titanium Block.
No Sex Age Clinical F/U(Mo) Radiologic F/U(Mo) Etiology Clinical result Level Degree of union
1 M 73 20 20 spondylolisthesis poor L4-5 complete union
2 F 47 17 15 spondylolisthesis good L4-5 complete union
3 F 55 17 17 stenosis good L5-1 complete union
4 M 64 19 19 spondylolisthesis fair L4-5 complete union
5 F 63 20 12 spondylolisthesis good L4-5 complete union
6 F 59 15 15 spondylolisthesis good L5-1 complete union
7 F 55 14 12 stenosis good L3-4 complete union
L4-5 complete union
8 M 57 14 12 stenosis good L1-2 complete union
L3-4 complete union
9 F 63 14 12 stenosis good L1-2 nonunion
L4-5 nonunion
10 M 55 12 12 spondylolisthesis excellent L4-5 complete union
11 F 70 15 15 stenosis good L2-3 complete union
L4-5 complete union
12 F 73 15 12 spondylolisthesis excellent L4-5 complete union
13 F 73 12 12 stenosis good L5-1 complete union
14 F 38 14 14 spondylolisthesis good L5-1 complete union
15 F 45 18 18 spondylolisthesis fair L3-4 complete union
16 F 45 13 13 spondylolisthesis good L4-5 complete union
17 F 44 12 12 spondylolisthesis good L4-5 complete union
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