Lumbar Spinal Rahisynthesis with Plif: a Retrospective Study of 58 Patients Demonstrating Imaging and Clinical Outcomes with One Year Follow-up.

Abstract

Background/objectives: Nowadays, posterior lumbar cages remain a popular choice among the available options for interbody fusion even when compared with anterior approaches. As the posterior lumbar anatomy permits a relatively easy exposure to the spinal anatomy of interest, expandable cages prove to be a reliable tool for 360-degree fusion. Our study aspires to investigate the postoperative effects of Flarehawk 9 after open posterior lumbar fixation.

Materials and methods: We retrospectively analyzed 58 patients (36 males and 22 females) with a mean age of 59.8 years (age range of 33 to 79 years) who underwent open posterior lumbar fixation and decompression using Flarehawk 9 as an interbody cage between September 2021 and February 2023, with a minimum follow-up of 12 months. Patients fit for surgery and with adequate surgical indications suffered from spinal canal stenosis, failed back surgery syndrome, or in need of revision surgery, recurrent disc herniation, spondylolisthesis with mechanical back pain and adjacent segment disease.

Results: Based on the Odeswery index, most of the patients who underwent posterior fixation presented a significant clinical improvement postoperatively. The rate of bony fusion can be affected by the number of fused levels and whether the patient underwent revision surgery. Our study suggested that the number of lordosis that the patients gained on average is 2±0.4 degrees.

Conclusions: The posterior lumbar approach is the golden standard of degenerative spinal surgery even compared to modern anterior approaches. Interbody cages can offer an improvement in fusion rate, lordosis and disc height. Large follow-ups are mandatory for the evaluation of each type of cage.