The Results of Long Segment Posterolateral Fusion in Degenerative Lumbar Spinal Disorders

Abstract

Purpose: The purpose of this study was to evaluate the safety and the validity of the long level posterolateral fusion with pedicle screw augmentation in the surgical treatment of degenerative lumbar spinal disorders in older patients. Materials and Methods: A radiological evaluation such as fusion rate, the changes of lordotic angle, metal failure and junctional problem, and clinical results about a 33 patients older than 50 years of age in whom a posterolateral fusion has been performed on more than three segments were analyzed. Results: Arthrodesis was obtained in 23 cases and the changes in the lordotic angle was 7.9. Satisfactory results were obtained in 20 cases, fair in 8 and poor in 5 cases. Satisfactory results were obtained in 12 of the 16 cases in which S1 was included in the arthrodesis and 8 of the 17 cases in which S1 was not included in the arthrodesis. The post-surgical complications encountered were as follows: Wound infection in 5 cases, metal loosening or failure in 12, bone graft donor site problem in 2 and junctional problems in 8 cases. Revision surgery was performed in 9 cases. Conclusion: Long segment fusion in degenerative lumbar spinal disorders should be considered carefully in old age because of the high rate of post-surgical complications and unsatisfactory clinical outcomes.