Evaluation of the clinico-radiological outcome of lumbar interbody fusion using cage and local bone graft in management of lumbar spondylolisthesis

Abstract

Background: Pain in the lower lumbar spine is a socioeconomically serious medical illness. The main reason from physiological perspective was micro and macro instability of spine. Posterior lumbar interbody fusion (PLIF) is a reliable treatment option for patients with spondylolisthesis; providing spinal stabilization in a balanced alignment with the disc space height being restored and with the neural elements being decompressed mechanically. Aims: To study clinical and radiological outcomes of Posterior lumbar interbody fusion with cage and local bone graft from laminectomy bone chips in lumbar spondylolisthesis.Material and Method: Our study includes 4 males and 8 females, aging 35-64 years. As per the Meyerding-evaluating system, 11 cases were classified as degree I, 1 cases as degree II, and 0 cases as degree III. The average follow-up duration was 18 months. The clinical outcomes were evaluated using the Oswestry Disability Index preoperatively and at 4th, 8th 12th, 18th month and the Kim & Kim criteria at last follow up. The radiological outcomes were evaluated as per the Modified Lee's criteria for fusion. Results: There were 7 cases of definitive fusion, 4 cases of probable fusion and 1 case of pseudoarthrosis, with a fusion rate of 91.67% (definitive 58.3 % + probable 33.3 %). The mean time for fusion was 16 months. There were no implant failures. According to Kim & Kim clinical criteria for scoring, the results were excellent in 9 cases, good in 2 cases, and fair in 1 case. The excellent and good rate was 91.66 %. Conclusion: PLIF with cage and bone graft from local laminectomy chips serves as a solid internal fixation and has the advantages of shorter operative time and less blood loss. This technique also provides excellent outcomes according to the clinical and radiological evaluation.