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Long-term outcomes of long level posterolateral fusion in lumbar degenerative disease: comparison of long level fusion versus short level fusion: a case control study.

Title
Long-term outcomes of long level posterolateral fusion in lumbar degenerative disease: comparison of long level fusion versus short level fusion: a case control study.
Author
이진규
Keywords
Degenerative spinal stenosis; Instrumented posterolateral fusion; Pedicle screw fixation; Long term outcome
Issue Date
2015-12
Publisher
BIOMED CENTRAL LTD
Citation
BMC MUSCULOSKELETAL DISORDERS, v. 16, Article number 381
Abstract
Background: We sought to evaluate the long-term outcomes of long-level instrumented posterolateral fusion (PLF) directly compared to those with short level instrumented PLF for degenerative spinal stenosis. Methods: From 1987-2002, patients who underwent instrumented PLF with wide decompression for degenerative spinal stenosis were reviewed. A total of 295 patients were available for follow-up over 10 years (mean, 14 years). These patients were divided into Group 1 (fusion of 1 or 2 levels) and Group 2 (fusion of three or more levels). Clinical and radiological outcomes were evaluated. Results: On clinical outcomes, Group 1 showed better results than Group 2 based on the Katz's Activities Daily Living index (p = 0.024), Kirkaldy-Willis criteria (p = 0.001) and the Korean version of the Oswestry disability index (p = 0.01). However, excellent and good outcome was noted in more than 64.5 % in Group 2. For radiological outcomes, overall fusion rate was higher in Group 1 compared with Group 2, but not significantly different (p = 0.35). However, the metal problems and surgical complications were more developed in Group 2 (p < 0.001). Although the radiologic changes on adjacent segments increased in accordance with the follow-up period, particularly in Group 2 (p < 0.001), no correlation with clinical symptoms was found. Conclusions: The long-level fusion group maintained acceptable clinical and radiological outcomes compared to the short-level fusion group at minimum of 10 years of follow-up.
URI
https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-015-0836-3http://hdl.handle.net/20.500.11754/29630
ISSN
1471-2474
DOI
10.1186/s12891-015-0836-3
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COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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