Anterior lumbar interbody fusion for internal disc disruption

Anterior lumbar interbody fusion was performed as the primary surgical procedure for 36 patients with internal disc derangement. Patients were selected on the basis of clinical complaints, discography, and magnetic resonance imaging results. Twenty-eight patients underwent a one-level fusion and eight patients had a two-level fusion for a total of 44 levels. Autogenous graft was used in all cases. Clinical results were categorized as success or failure based on return to work or activities of daily living, drug usage patterns, and complaints of pain. Thirty-one patients (86.1%) had a successful clinical result and five patients (13.9%) had an unsuccessful clinical result. Based on flexion-extension radiographs fusion was achieved in 32 patients (88.9%). Forty of the forty-four levels (90.9%) fused. Complications include one each of: pulmonary embolus, retrograde ejaculation, wound hematoma at the donor site, and perioperative graft extrusion.