Manoj Krishna Raymond Pollock Chandra Bhatia
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Transcript of Manoj Krishna Raymond Pollock Chandra Bhatia
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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 BhatiaSpine unit, University Hospital of North TeesStockton-on-Tees
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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 TeesStockton-on-Tees
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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.
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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
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17.1%Spondylo
14.5%Postlamin
5.3%DProlapse 63.2%
DDD
Diagnosis of Patients Undergoing PLIF
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52.9
29.1
0
10
20
30
40
50
60
Baseline Follow-up
Osw
estry
Dis
abili
ty In
dex
t-test P = 0.001
95% CI for difference (23.8) = 18.4 – 29.2
Outcomes: ODI
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Outcomes: VAS scores7.7
6.6
3.8 3.2
0
2
4
6
8
10
Back Leg
VAS Pain Score
Baseline
Follow-up
t-test back pain P = 0.00195% CI for difference (3.9) = 3.2 – 4.8
t-test leg pain P = 0.00195% CI for difference (3.3) = 2.0 – 4.3
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SF-36 Scores
Dimension Improvement % P valuePF 69 0.001BP 68 0.001GH 16 0.001VT 48 0.001SF 43 0.001MH 12 0.022RE 14 0.006RP deteriorated
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Summary
• ODI- 45% improvement
• VAS Back- 51% improvement
• VAS Leg- 50% improvement
• SF-36- 12-69% improvement
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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
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Clinical Results
• 68% of patients had significant improvement 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).
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Conclusion
PLIF surgery reduces pain, improves functioning and quality of life in patients with chronic low back & leg pain, unresolved by
conservative therapy
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Further Advancement
• Our current technique involves less invasive surgery and results are much better than the results presented.
• We will present these results in a future meeting.
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THANK YOU
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