Abstract
We treated 72 patients (31 males, 41 females, mean age 65.9 years) with PLIF between April 2006 and March 2009. In this series we experienced 3 cases of radiculopathy because of adjacent segment disorders.
The first patient was a 56-year-old woman who developed a lumbar disc hernia at the L5/S level 18 months after L4/5 level PLIF. She was treated surgically by L5/S microendoscopic discectomy (MED). However, 2 weeks after surgery, she suffered lumbar disc hernia at the same level again, and was treated surgically with MED.
The second patient was a 66-year-old man who developed lateral lumbar disc hernia at the L5/S level 6 months after L4/5 level PLIF. He recovered after several sessions of nerve root block treatment.
The third patient was a 68-year-old man, who also developed lateral lumbar disc hernia at the L5/S level 3 months after L3/4 4/5 level PLIF. Nerve root block was ineffective, so he was treated surgically with lateral foraminotomy at the L5 level. However, 3 months after the second operation, the same symptom occurred, and therefore he finally underwent surgery with PLIF at the L5/S level.
Our experience suggests that considerable attention should be paid to the adjacent segment when performing PLIF if the patient has disc degeneration at the adjacent segment, and that the surgical method may need to be changed in such a case.
