Study design: Retrospective study on the incidence of reoperation in patients previously treated by instrumented posterior lumbar interbody fusion.
Objectives: To answer the following questions: Reoperation rate after PLIF? And is there any influence of the length of fusion on the reoperation rate?
Summary of background data: The use of different techniques demonstrates that there is currently no ideal procedure for lumbar fusion. The instrumented posterior lumbar interbody fusion (PLIF) shows a comparable success rate to the so-called 360 degrees fusion techniques (combined dorsoventral spondylodesis) without the need of an anterior approach.
Methods: We reviewed 1680 patients who underwent a PLIF at our institution between January 1995 and December 2000. A total of 3053 levels were fused. The reoperation rate was analyzed. The mean follow-up was 5 years.
Results: There were 221 (13.2%) reoperations in 206 patients (12.2%). Of 1680 PLIFs, 312 were multisegmental (>2 segments). Within this group, 45 (14.4%) revisions were done. We found that the most important difference between the multisegmental PLIFs and the mono- or bisegmental PLIFs is the rate of adjacent segment decompensation (5.1% vs. 2.3%), and this was statistically significant. The reoperation rate between those two groups was only slightly different with 12.9% for mono- or bisegmental and 14.4% for multisegmental PLIFs.
Conclusions: The fusion length does not show a significant difference in the reoperation rate as such. Nevertheless, we registered a significantly higher incidence for decompensation of adjacent segments after multisegmental PLIFs.