Posterior Outcomes of Posterior Lumbar Interbody Fusion with High-Angle Cages and Posterior Column Osteotomy: Can This Procedure Adequately Correct Local Alignment and Help Achieve Good Bone Union?

Abstract

Introduction: We have combined high-angle cage and posterior column osteotomy (HAP) in posterior lumbar interbody fusion (PLIF) surgery (PLIF with HAP), focusing on local lumbar alignment correction and bone fusion. We report the postoperative outcomes of PLIF with HAP at our hospital.

Methods: PLIF with HAP was performed in 70 patients at our institution between April 2020 and November 2021. In surgery, total facetectomy was performed, and a 12° titanium cage was used. Percutaneous pedicle screws were inserted, and all cases underwent compression with the screws. The following items were examined: operative time, blood loss, preoperative lumbar BMD, at pre-/post-/postoperative 6-month slip length (%slip), segmental lumbar lordosis (SLL), ratios of mean disc height to vertebral body height and posterior disc height to vertebral body height on lumbar lateral X-ray, at pre-/postoperative 6-month JOA score, VAS for lumbar pain, bone fusion rate on computed tomography (CT) at 6 months postoperatively, and postoperative complications.

Results: There were considerable differences in %slip and SLL at pre-/postoperatively and pre-/6 months postoperatively. And there was considerable differences in JOA and lumbar pain VAS at pre-/6 months postoperatively. The bone fusion rate was 92.9% at 6 months postoperatively. Complications included one case of transient neuralgia.

Conclusions: Corrected local alignment and bone fusion for PLIF with HAP were good.