Abstract
Many methods of posterior lumbar interbody fusion (PLIF) have been reported since Cloward introduced the procedure in 1943 for treatment of lowback pain due to ruptured interververtebral discs. We report a case of lumbar spinal canal stenosis with instability treated with PLIF using a new type of prosthesis : a thin walled, threaded tubular shell of titanium. A 53yearold man was admitted complaining of lowback pain, pain and numbness of the left lower extermity, and left drop foot. Lumbar spinal canal stenosis at the L4-5 level with instability was diagnosed, and PLIF was performed using the threaded fusion cage system. We exposed the posterior aspects of L4 and L5 using standard methods. The herniated nucleus pulposus of L4-5 was first resected, then two threaded fusion cages were inserted into the L4-5 intervertebral space. Chips of cancellous bone, taken from the nearby iliac crest, were tightly packed into the cages. Although this fusion device was introduced by Ray in 1991, this is its first reported use in Japan.
