A modified posterior spinal fusion technique: surgical technique and clinical outcome in minimal 2-year follow-up

Background: Fusion of the spine region for congenital, traumatic, and degenerative lesions is more common now. Many orthopedic surgeons prefer posterior arthrodesis to restore the stability. Several studies have reported benefits, technical demands, clinical results, and postoperative complications with each method. For lumbar spine fusion, the best technique for a particular patient remains controversial.

Objective: We described a technique of posterior spinal fusion that can achieve solid fusion and produce clinical success.

Method: Between June 2008 and May 2010, a single surgeon treated 46 patients with this modified technique of posterior spinal fusion. All patients underwent postoperative computed tomography (CT) with coronal and sagittal three-dimensional reconstruction in assessing lumbar spine fusion. All patients were instructed to complete a self-assessment Oswestry Disability Index (ODI) questionnaire. These patients were analyzed for clinical outcome and fusion rate.

Results: The study group included 24 women and 22 men with a mean age of 71.2. Mean operating time was 106 minutes in a single-level fusion, 133 minutes in a two-level fusion, 210 minutes in a three-level fusion, and 288 minutes in a four-level fusion. The amount of blood loss during the operation and on the first postoperative day was 632 ml in a single-level fusion, 738 ml in a two-level fusion, 986 ml in a three-level fusion, and 1122 ml in a four-level fusion. There were postoperative complications in two patients. The minimum follow-up period was two years. Postoperative ODI was reduced significantly and had evidence of spinal fusion in CT scan assessing.

Conclusions: This posterior spinal fusion technique is effective in degenerative lumbar disease. Success rates have also been noted. This method of fusion can give the osseous fusion. It may also improve the clinical outcome. This modified posterior spinal fusion technique has some benefits when comparing to the previous methods.