Posterior Lumbar Interbody Fusion in Degenerative Lumbar Spine Disease and Risk of Adjacent Segment Disease

  • IJAZ HUSSAIN WADD Punjab Institute of Neurosciences (PINS), Lahore General Hospital, Lahore
  • ASIF SHABIR Punjab Institute of Neurosciences (PINS), Lahore General Hospital, Lahore
  • LIAQAT MEHMOOD AWAN Punjab Institute of Neurosciences (PINS), Lahore General Hospital, Lahore
  • SYED MOHSIN AJMAL Punjab Institute of Neurosciences (PINS), Lahore General Hospital, Lahore
  • HUMAIRA MUSHTAQ Punjab Institute of Neurosciences (PINS), Lahore General Hospital, Lahore
  • RIZWAN MASOOD BUTT Punjab Institute of Neurosciences (PINS), Lahore General Hospital, Lahore
Keywords: Lumbar Spinal Fusion and Fixation, Adjacent Segment Disease, Outcome of Patients


Objective:  To determine the chances of adjacent segment disease (ASD) and risk factors after posterior lumbar interbody fusion (PLIF).

Material and Methods: 110 patients of both genders with degenerative lumbar instability at L4/5 level were included in my study. We did PLIF in all our patients and followed our patients for one year. The following parameters were measured: the degree of lumbar lordosis, the degree lumbosacral angle, the disc space height and their dynamic angulation and the displacement of L3 over L4. We checked the outcome with the help of the Japanese orthopedic association (JOA) and Oswestry disability index (ODI). We divided the patients into groups A and B; group A includes patients with progression of degeneration at the proximal level (L3-L4), while group B with no progression of disease at proximal level.

Results:  The 86 patients (78.18%) were in group A, and 24 patients (21.88%) were in group B. There were no significant difference in radiological parameters of both groups; lumbosacral angle of lordosis, L3 laminar inclination angle, preoperative degenerative changes at proximal level, L4–L5 lordosis and BMD before surgery. The clinically and statistically significant differenceswere of the age of the patients falling in two groups. We found that at the completion of study ODI and JOA were not significantly different in both groups (P >0.05).

Conclusion:  Degenerative lumbar disease is an age related disease with no significant effect of radiological degenerations on the final outcome of our patients.No other possible risk factor has a significant effect on outcome.


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Original Article