Abstract
Object: To study the incidence, etiology and management of patients with neuralgia following Posterior Lumbar Interbody Fusion (PLIF).
Design: A prospective study of 85 patients undergoing PLIF surgery from March 1996 to March 2001.
Subjects: Seven of the 85 patients undergoing PLIF surgery developed new leg pain between three days and five months following surgery.
Results: The incidence of neuralgia was 8%. In all the patients the post-surgical neuralgia was in a new distribution. MRI examination ruled out misplaced pedicle screws in all cases, but was otherwise unhelpful. One patient developed neuralgia five months post-operatively due to collapse of the cortico-cancellous graft and secondary foraminal narrowing. This was not relieved following surgical decompression. Four patients had neuralgia caused by relative stenosis of the exiting nerve (3) or the traversing nerve (1) which started between three days and two weeks after surgery. The pain was relieved in all four following surgical decompression. One patient had leg pain when lying down; standing and sitting relieved this. A loose lamina was found on exploring the wound. Her pain settled after surgery. One patient developed a spondylolisthesis at the level below a L4/5 PLIF four months after surgery. Her pain was eased by stabilization of the lower segment.
Conclusions: MRI scans are not very helpful in these cases. Early exploration is recommended and gave good results in six of our seven cases.
Abstracts prepared by Mr. A. J. Stirling, FRCS, and Miss A. Weaver. Correspondence should be addressed to Miss A. Weaver at the Research and Teaching Centre, Royal Orthopaedic Hospital, Northfield, Birmingham, B31 2AP, UK
BritSpine 2002, the second combined meeting of the British Association of Spinal Surgeons, the British Cervical Spine Society, The British Scoliosis Society and the Society for Back Pain Research, took place at the International Convention Centre in Birmingham UK between 27th February and 1st March 2002. The following presentations and posters were given and displayed.
