Abstract
Several surgical options have been utilised to treat patients with back dominant lumbar disc disease. The purpose of our study was to compare the outcomes in patients who underwent lumbar fusion with an expandable interbody device (B-TWIN) using different surgical techniques (PLIF, TLIF or posterolateral screws alone)
Observational study, retrospective analysis of prospectively collected data. Patients underwent a single level lumbar fusion. Group A: PLIF with B-Twin cage; Group B: TLIF with B-Twin cage and unilateral pedicle screw fixation and Group C: bilateral posterolateral screw fixation alone.
Functional outcomes were assessed using: SF-36, Oswestry Disability Index (ODI), Distress and Risk Assessment Method scores (DRAM) and the visual analogue pain scores (VAS).
There were 32 patients, 24 female and 8 male. Average age was 45 (range 33-63). Average follow up was12 months (range 2-36). Level of spinal fusion was 2 L3/4, 11 L4/5 and 13 L5/S1. Mean hospital stay was 5.8 days.
VAS improved in all 3 groups A 5.83 – 5; B 8 – 4.83; C 5.71 – 2.3.
ODI improved in all 3 groups A 0.5 – 0.35; B 0.51 – 0.44, C 0.42 – 0.16.
There was no statistical difference on comparison of the three groups.
There were no operative complications. One patient broke her interdody device during a all in the first post-operative week requiring a subsequent procedure.
Lumbar interbody fusions can safely be performed using an expandable interbody device. Good functional outcomes can be achieved in the majority of well selected patients
