[Posterior lumbar interbody fusion (PLIF stand-alone) for chronic low back pain]

To evaluate the fusion achieved by posterior lumbar interbody fusion--PLIF [B-TWIN, Disc-O-Tech) stand-alone in terms of intervertebral fusion on the basis of radiograph imaging.

Lumbar fusion is being used to reduce pain and decrease disability in patients with chronic low back pain. Different surgical techniques are available. The use of PLIF stand-alone has been described with controversial results.

From 2003 through 2006, 14 patients with chronic low back pain were operated on in our department. In order to evaluate the quality of fusion, flexion and extension, radiographs were performed. A difference of 4 degrees was considered as failure of fusion.

A total of 14 patients, 5 male and 9 female mean age 56 years (43-72), underwent 15 lumbar interbody fusions. Fourteen lumbar interbody fusions (93%) had less than 4 degrees of difference between flexion and extension radiographs; the overall median score was 1.7 degrees, the male group had a median score of 2.9 and the female group 1.1 (P = 0.066]. All the patients with degenerative disc disease had scores above 1.7 degrees, 57% (4) of the patients with spondylolisthesis had scores above 1.7 degrees and 1 patient (16% of this group) with spinal stenosis had a score above 1.7 degrees (P = 0.096).

A fusion rate of 93% was achieved. The findings suggested a tendency for better results in the female group and better results in the spinal stenosis group compared with the spondylolisthesis group and the degenerative disc disease group. There is a need for further investigation in order to establish our findings.