High Fusion Rates Achieved With New PLIF Technique

Posterior lumbar interbody fusion (PLIF) performed with posterior instrumentation to treat degenerative lumbosacral spine disease proved as effective as the typical pedicle screw posterior lumbar interbody fusion, but investigators noted in a new study the technique may help reduce intraoperative complications.

“UC (Universal Clamp), a novel semirigid sublaminar posterior instrumentation, combined with wedge-shaped PEEK [polyetheretherketone] PLIF corrected both global and segmental sagittal lumbar alignment and achieved fusion rate similar to that historically reported with pedicle screw-PLIF techniques, however, avoiding intraoperative complications associated with the use of pedicle screws,” Stergios Tegos, M.D., Ph.D., and colleagues, from Athens, Greece, wrote in the study.

Among 295 patients who, between February 2009 and February 2011, underwent posterior decompression and 360-degree stabilization with PLIF and UC sublaminar fixation at one to five levels, the investigators studied 150 patients with a minimum 24 month follow-up. There were 80 women and 70 men with a mean age of 48 years, according to the abstract.

The UC instrumentation proved to be an effective way to treat degenerative lumbar spine disease with pain and/or claudication, Tegos and colleagues noted.

According to the findings, at two years postoperatively the mean Oswestry disability scores improved significantly and there was no instrumentation failure nor did the UC band or PEEK cage protrude into the spinal canal. In addition, no patients required additional spine surgery through the final evaluation period.

“The achieved fusion rate with 360-degree instrumentation was as high as 94 percent, whereas global and segmental sagittal lumbar balance was restored, and this restoration was maintained in the short-term follow-up. The novel UC instrumentation that was applied in this series of 150 patients was not only effective in achieving spinal fusion but also safe, avoiding neurological complications, performed under direct vision of surgeon avoiding the need for unnecessary irradiation,” Tegos and colleagues wrote.