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Updated: Sep 27, 2025

Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
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Better Functional Recovery After Single-Level Compared With Two-Level Posterolateral Lumbar Fusion.

Scott D Daffner1, Joshua T Bunch2, Douglas C Burton2

  • 1Department of Orthopedics, West Virginia University School of Medicine, Morgantown, USA.

Cureus
|April 15, 2022
PubMed
Summary

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This summary is machine-generated.

Single-level posterolateral lumbar fusion (PLF) offers better functional outcomes and patient satisfaction than two-level PLF. Both procedures show comparable fusion rates, pain relief, and quality of life improvements.

Area of Science:

  • Orthopedics
  • Neurosurgery
  • Spine Surgery

Background:

  • Posterolateral lumbar fusion (PLF) is a common procedure for spinal conditions.
  • Existing research often compares single-level to multilevel PLF but lacks direct comparison between single-level and two-level PLF.
  • Patient outcomes after single-level versus two-level instrumented PLF require further investigation.

Purpose of the Study:

  • To prospectively compare outcomes between single-level and two-level instrumented PLF.
  • To evaluate differences in radiologic outcomes, pain levels, disability, and quality of life.

Main Methods:

  • Prospective cohort study involving 42 patients across nine US centers.
  • Data collected included Visual Analog Scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and 36-Item Short Form Survey version 2.0 (SF-36v2) for quality of life.
Keywords:
bone graft materialsdegenerativeinstrumented posterolateral fusion (plf)novel bone graft substituteoswestry disability index (odi)outcomespatient satisfactionquality of lifesingle-leveltwo-level

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  • Follow-up assessments were conducted at six weeks and three, six, 12, and 24 months post-surgery.

    • Main Results:

    • Both single-level and two-level PLF demonstrated improvements in ODI, SF-36v2 Mental Component Score (MCS), and VAS pain scores by the first follow-up.
    • Single-level PLF showed a statistically significant greater improvement in ODI (5.86 points) compared to two-level PLF.
    • Fusion rates were comparable between groups, with surgeon CT evaluation showing 67.6% at 12 months and 94.1% at 24 months, and third-party evaluation showing 81.1% at 12 months and 86.5% at 24 months.

    Conclusions:

    • Single-level PLF is associated with better functional outcomes and higher patient satisfaction compared to two-level PLF.
    • Both procedures yield similar fusion rates, pain reduction, and improvements in generic health-related quality of life.
    • Both single-level and two-level PLF are effective in achieving high fusion rates and improving patient-reported outcomes.