Posterior Lumbar Interbody Fusion with Pedicular Screwing in Advanced Aged Patients

Even when patients with lumbar spinal instability are of advanced aged, we need to consider lumbar spinal fusion according to their activities of daily livng.Operative results and problems of posterior lumbar interbody fusion (PLIF) are investigated in patients over 65 years old.Twenty patients underwent PLIF with Steffee VSP. Ten patients were male and ten female. Their ages ranged from 65 to 83 years with an average of 71.8 years. There were eleven patients with degenerative spondylolisthesis, four with spondylolytic spondylolisthesis and five with lumbar canal stenosis. The follow-up periods ranged from six months to 3.5 years with an average of 1.5 years. Clinical results were evaluated according to the JOA (Japanese Orthopedic Association) score.Small collapse of the grafted bone was seen in seven patients, however, all patients successfully gained intervertebral bony union. The average JOA score was 14.0 points preoperatively, and this improved to 22.8 points postoperatively. The average ratio of improvement was 60.5%. Applications of PLIF for single disc lesions brought better clinical results than those for multiple disc lesions.We concluded that PLIF is a very effective method for complete decompression of spinal roots and rigid intervertebral bony union even in advanced aged patients.