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PRIMARY TWO-LEVEL LUMBAR FUSIONS (L4-L5-S1) FOR DEGENERATIVE DISC DISEASE



Abstract

This was a retrospective review with minimum two-year follow-up of 52 patients treated between 1989 and 1998 with a variety of fixation methods. All patients had posterolateral fusions (after McNab). In addition, 27 patients had interbody fusions (23 with Brantigan or Harms cages). Fixation was by interlaminar screws in 13 (modified Nagerl technique), 18 with Roy Camille or AO notched spinal plates and in 21 with rigid fixation (6 VSP and 15 Diapason).

A good result was defined as a pain level of less than four out of 10 and an Oswestry Disability Score of less than 30%. Only 13 patients achieved a good result. The best results were seen in the patients with rigid fixation (8 out of 21). A fusion rate of 100% was achieved in patients who had an interbody cage and rigid fixation.

These results were compared with results from other papers in the literature. Social factors are important criteria for patient selection. No patient without a “significant partner” achieved a good result.

The abstracts were prepared by Professor A. J. Thurston. Correspondence should be addressed to him at the Department of Surgery, Wellington School of Medicine, PO Box 7343, Wellington South, New Zealand