Our Summary

This research paper explores the effectiveness of a surgical treatment called posterior lumbar interbody fusion for a specific spinal condition, double-segmental bilateral isthmic lumbar spondylolisthesis. This condition is a type of spinal disorder where one vertebra slips forward onto the bone directly beneath it.

The study was conducted on 17 patients, which included 12 males and 5 females whose ages ranged from 48 to 69 years. These patients had the disease for a duration ranging from 11 months to 17 years. The severity of their condition was classified using the Meyerding classification system, with most of them having degree I, few having degree II, and one having degree III.

The surgery was successful in most patients, with a significant decrease in their pain levels. There was a minor complication in two cases where there was leakage of cerebrospinal fluid due to a tear in the dura (the outermost of the three layers of the meninges surrounding the brain and spinal cord) during surgery. However, there were no other operation-related complications.

The patients were followed up for a period of 1 to 6 years (averaging 3.4 years). The results showed that the surgery was effective in reducing the slippage of the vertebrae, with a complete reduction rate of 85% at 1 week after operation. All patients achieved bony union (healing of the bone) within 6 to 12 months.

The study concludes that the surgical treatment can provide satisfactory results. However, the success of the operation depends on several factors such as accurate insertion of the screw, effective decompression, distraction before reduction, rational use of pulling screws, and interbody fusion.

FAQs

  1. What is posterior lumbar interbody fusion and what condition does it treat?
  2. What was the success rate of the surgery and were there any complications?
  3. What factors influence the success of the posterior lumbar interbody fusion operation?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lumbar fusion is to follow post-operative care instructions carefully to ensure proper healing and recovery. This may include restrictions on activities, physical therapy exercises, and taking prescribed medications. It is also important to attend follow-up appointments with your doctor to monitor progress and address any concerns. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can help support the healing process and prevent future spine issues.

Suitable For

Patients who are typically recommended lumbar fusion are those with severe spinal conditions such as double-segmental bilateral isthmic lumbar spondylolisthesis. These patients may have tried conservative treatments without success and are experiencing significant pain and functional limitations. Patients who have not responded to non-surgical treatments such as physical therapy, medications, and injections may be candidates for lumbar fusion surgery. Additionally, patients with progressive neurological deficits, instability of the spine, or spinal deformities may also be recommended for lumbar fusion. It is important for patients to undergo a thorough evaluation by a spine specialist to determine if lumbar fusion is the appropriate treatment option for their specific condition.

Timeline

Before lumbar fusion:

  • Patients experience chronic lower back pain, numbness, and weakness in the legs
  • Patients undergo diagnostic tests such as X-rays, MRI, and CT scans to determine the severity of the spinal condition
  • Patients may undergo conservative treatments such as physical therapy, medications, and injections to manage their symptoms
  • If conservative treatments are not effective, patients may be recommended for lumbar fusion surgery

After lumbar fusion:

  • Patients undergo pre-operative preparation including medical evaluations and discussions with the surgical team
  • Patients undergo lumbar fusion surgery, where the damaged disc is removed and the vertebrae are fused together using bone grafts and hardware such as screws and rods
  • Patients are monitored in the hospital for a few days post-surgery for pain management and to monitor for any complications
  • Patients undergo physical therapy and rehabilitation to regain strength and mobility in the spine
  • Patients are followed up with for an extended period to monitor the success of the surgery and to address any post-operative issues that may arise

What to Ask Your Doctor

Some questions a patient should ask their doctor about lumbar fusion include:

  1. What are the potential risks and complications associated with lumbar fusion surgery?
  2. What is the success rate of lumbar fusion surgery for my specific condition?
  3. What is the expected recovery time and rehabilitation process after lumbar fusion surgery?
  4. Will I need to undergo physical therapy or other treatments post-surgery?
  5. How will lumbar fusion surgery affect my daily activities and quality of life?
  6. Are there any alternative treatments or therapies available for my condition?
  7. How long will the benefits of lumbar fusion surgery last?
  8. What is the long-term outlook for my condition after lumbar fusion surgery?
  9. How many lumbar fusion surgeries have you performed, and what is your success rate?
  10. Are there any specific precautions or lifestyle changes I should make before and after lumbar fusion surgery?

Reference

Authors: Xing W, Huo Hongjun, Yang X, Xiao Y, Zhao Y, Fu Y, Zhu Y, Li F, Xin D. Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2015 Dec;29(12):1500-3. PMID: 27044218