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Segmental ("floating") lumbar spine fusions.

A E Brodsky1, R L Hendricks, M A Khalil

  • 1Texas Institute for Spinal Disorders, Houston.

Spine
|April 1, 1989
PubMed
Summary
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Segmental or "floating" fusion for L4-5 discopathy is effective, challenging traditional surgical dogma. This approach yielded excellent or good results in over 83% of patients, with minimal need for further intervention.

Area of Science:

  • Orthopaedic Surgery
  • Spinal Fusion Techniques

Background:

  • Traditional orthopaedic surgery mandates lumbosacral joint inclusion for L4-5 fusion.
  • This long-standing practice lacks supporting scientific literature.

Purpose of the Study:

  • To evaluate the efficacy of segmental or "floating" fusion for L4-5 discopathy or instability.
  • To challenge the traditional dictum of including the lumbosacral joint in L4-5 fusion procedures.

Main Methods:

  • A retrospective review of 206 segmental "floating" fusions performed over 32 years.
  • Follow-up assessment of 184 patients to evaluate surgical outcomes.

Main Results:

  • 83.7% of patients achieved "Excellent" or "Good" outcomes.
  • 15.2% of patients had "Fair" results, and 2% had "Poor" results.

Related Experiment Videos

  • Only 2.7% of patients required subsequent intervention for lumbosacral disc herniation.

    • Conclusions:

    • Segmental or "floating" fusion is a viable and effective alternative for L4-5 discopathy or instability.
    • The necessity of including the lumbosacral joint in L4-5 fusion is questionable.
    • This technique demonstrates favorable long-term outcomes with low complication rates.