A comparison of single-level fusions with and without hardware

Area of Science:

• Spine Surgery
• Orthopedic Research
• Biomechanical Engineering

Background:

• Degenerative disc disease and associated chronic low back pain are prevalent.
• Failed conservative treatments necessitate surgical intervention for lumbar fusion.
• Adjunctive spinal fixation techniques are increasingly utilized in fusion procedures.

Purpose of the Study:

• To compare the efficacy of single-level lumbar fusion with and without pedicular fixation.
• To evaluate the impact of pedicular fixation on fusion rates, pain reduction, and return to work.
• To determine if spinal fixation improves outcomes in patients with single-level disc disease.

Main Methods:

• Prospective study of 68 patients over 47 months.
• Comparison between lumbar fusion without hardware (29 patients) and with VSP pedicular fixation (39 patients).
• Evaluation criteria included fusion success (pseudarthrosis), perceived pain levels, and return to work status.

Main Results:

• Pseudarthrosis occurred in 58.6% of the noninstrumented group versus 0% in the instrumented group.
• Pain improvement was 41.4% in the nonhardware group and 76.9% in the hardware group.
• Return to work rates were 31% for noninstrumented and 72% for instrumented patients.

Conclusions:

• Adjunctive pedicular fixation significantly enhances fusion rates in single-level lumbar fusion.
• Spinal fixation leads to superior pain relief and higher rates of return to work.
• The use of spinal fixation is recommended for improving outcomes in single-level lumbar fusion procedures.