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Laparoscopic spinal fusion of L4-L5 and L5-S1
B P Geerdes1, C W Geukers, W F van Erp
1Department of General Surgery, Deaconess Hospital, DS Theodoor Fliednerstaat 1, The Netherlands.
Background:
Patients with degenerative disc disease were treated by laparoscopic spondylodesis. Clinical outcome and quality of life were then analyzed in a retrospective study.
Methods:
Thirty patients with a mean age of 43 years (range, 26-63) who suffered from instability of levels L4-L5 (n = 23), L5-S1 (n = 3), or both (n = 2) underwent surgery. Spondylodesis was achieved with two BAK cylinders. After 6 months, all patients completed a questionnaire designed to assess satisfaction with the operative outcome.
Results:
After a median follow-up of 2.3 years (range, 0.9-3.5), 23 patients were free of pain or greatly improved. Complications included bleeding (n = 2), cage displacement (n = 1), retrograde ejaculation (n = 3), and postoperative ileus (n = 1). Good improvement was reported in daily activities and quality of life.
Conclusion:
Laparoscopic spondylodesis has a good clinical outcome with a low rate of morbidity. Notable improvements can be achieved in terms of daily activities and quality of life; however, these improvements are moderate in degree, and patient activity remains somewhat limited.