Posterior lumbar interbody fusion (PLIF) in lumbar spine infection

Abstract

Objective The aim of the study is to evaluate the clinical and radiographic outcomes for patients undergoing posterior lumbar interbody fusion in the treatment of lumbar spine infection. Patients and methods This retrospective study included 16 patients (10 men and six women); their mean age was 55.0±8.61 years, presented with lumbar infection treated surgically through posterior approach after failure of conservative treatment. Registration Number:- Ortho-surg._4Med.Research_PED.Def._0000004. All patients underwent clinical assessment, laboratory investigations included erythrocyte sedimentation rate in the first hour, white blood cell and C-reactive protein and radiological evaluation included conventional radiographs, computed tomographic scan, and MRI. Pain and disability scores were collected preoperatively and postoperatively including back and bilateral leg pain visual analog scale (VAS) scores. In 10 patients, the lesion was located in a single level, whereas in six patients two levels were affected. The surgical maneuver included posterior instrumentation, disc space debridement, and grafting. The mean follow-up period was 31.50±4.23 months. All patients agreed to be included in this study. Results There were no instances of intraoperative complications or delayed complications requiring subsequent interventions. Patients demonstrated statistically significant reductions in the back and leg pain VAS. The average intraoperative time consumed for the whole surgery was 156 min; the average blood loss for this procedure was 812 ml. The mean postoperative hospital stay was 4.6 days. All patients showed improved VAS. Fifteen patients out of 16 have solid fusion with a fusion rate of 93.75±2.5%. The average postoperative kyphosis decreased from 15 to 8. Conclusion This study demonstrated that single-stage debridement and instrumentation using the posterior approach (posterior lumbar interbody fusion) appears to be a safe approach in treating lumbar spine infections with no infection recurrence. Pain, neurological deficits, and spinal deformity are likely to improve after surgery.