Abstract
The success of lumbar spine fusion depends on good patient selection and bone grafting technique. Instrumentation of the fusion, now popular, improves fusion rates, eliminates the need for postoperative braces and allows early mobilisation. However, the stress shielding caused by rigid internal fixation is thought to lead to osteopoenia and degeneration of adjacent segments. Theatre times, intra-operative complications and costs are increased when pedicle screw fixation is added.
This is a report of a pilot study of eight patients who had one-level fusion and unilateral instrumentation between 1998 and 2000. Theatre time, fusion rate and functional outcomes were evaluated. The minimum follow-up time was eight months. Fusion was achieved in all patients and there was no metal failure. One patient continued to have back and leg pain in spite of a solid fusion.
Although this is a small study undertaken over a short period, the results suggest that unilateral pedicle screw fixation can be safely undertaken.
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at The Department of Orthopaedic Surgery, Medical School, University of Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193 South Africa
