POSTEROLATERAL LUMBAR FUSION - OUTCOME OF 71 CONSECUTIVE OPERATIONS AFTER 4 (2-7) YEARS

We report the outcome of 71 consecutive posterolateral lumbar fusions without spinal instrumentation. The indication for the operation was s pondylolysis-olisthesis, degenerative disc disease/facet joint arthros is, or pain after prior laminectomy. Concerning pain relief, 29/43 pat ients with spondylolysis-olisthesis were classified as good. The corre sponding figures in the group with degenerative disc disease and/or fa cet joint arthrosis were 8/16 patients and in the group with pain post -laminectomy, 6/12 patients. No surgical complications were noted. In the total material 54 patients had a solid fusion, as defined by radio graphic osseous trabecular bridging at all intended levels. One-level fusions tended to heal solidly in a higher frequency than two-level fu sions. For the spondylolysis-olisthesis group, healed fusion correlate d with a good clinical result. Such a correlation could not be verifie d for the other diagnostic groups. We conclude that non-instrumented p osterolateral lumbar fusion is a valid method for treating low-grade s pondylolysis-olisthesis, especially when the aim is to fuse a single l evel. Improved patient selection methods are required in fusion for de generative disc disease and pain after laminectomy.