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Long term follow-up of patients undergoing Posterior Lumbar Interbody Fusion (PLIF) Surgery A review of 182 cases . Manoj Krishna Raymond Pollock Chandra Bhatia. Spine unit, University Hospital of North Tees Stockton-on-Tees. www.spinalunit.org. www.spinalunit.org. Methods.
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Long term follow-up of patients undergoing Posterior Lumbar Interbody Fusion (PLIF) SurgeryA review of 182 cases Manoj Krishna Raymond Pollock Chandra Bhatia Spine unit, University Hospital of North Tees Stockton-on-Tees www.spinalunit.org www.spinalunit.org.
Methods • Study period March 1997 to November 2003 • 226 patients underwent PLIF • 182 patients have both baseline & follow-up (80% response) • Outcomes measured at baseline (pre-op) and at a single follow-up (post-op) • Mean follow up – 26 months Spine unit, University Hospital of North Tees Stockton-on-Tees www.spinalunit.org.
Outcome Measures • Oswestry disability index (ODI)* • VAS for back and leg pain • SF-36 *9 section NASS ODI used, with each section scored 0-5 www.spinalunit.org.
Patients • 182 patients • 99 females • 83 males • Mean age = 45.3 yrs • 110 one level fusion • 72 two level fusion • Duration of symptoms- median 63 months www.spinalunit.org.
Outcomes: ODI t-test P = 0.001 95% CI for difference (23.8) = 18.4 – 29.2 www.spinalunit.org.
Outcomes: VAS scores t-test leg pain P = 0.001 95% CI for difference (3.3) = 2.0 – 4.3 t-test back pain P = 0.001 95% CI for difference (3.9) = 3.2 – 4.8 www.spinalunit.org.
SF-36 Scores www.spinalunit.org.
Summary • ODI- 45% improvement • VAS Back- 51% improvement • VAS Leg- 50% improvement • SF-36- 12-69% improvement
Complications • Dural tear- 12 • Neuralgia- 16→ 6 persistent leg pain • Infection- • Superficial-8, Deep-2. • Bone graft pain- 3 • Pedicle fracture- 2 • Brachial neuropraxia- 1 www.spinalunit.org.
Clinical Results • 68% of patients had significantimprovement in Oswestry scores (>15%). • 79% of patients had significant decrease in VAS for Back pain (change >2 points). • 68.3% of patients had significant decrease in VAS for leg pain (change>2 points). www.spinalunit.org.
Conclusion PLIF surgery reduces pain, improves functioning and quality of life in patients with chronic low back & leg pain, unresolved by conservative therapy www.spinalunit.org.
Further Advancement • Our currenttechnique involves less invasive surgery and results are much better than the results presented. • We will present these results in a future meeting. www.spinalunit.org.
THANK YOU www.spinalunit.org www.spinalunit.org.