Trend indicates less adjacent-segment morbidity, fewer reoperations than fusion surgeries
MONDAY, Nov. 9 (HealthDay News) -- Ligamentoplasty may be associated with less adjacent-segment disease and fewer reoperations compared with lumbar fusion surgery, according to a Japanese study published in the October issue of the Journal of Spinal Disorders & Techniques.
Masahiro Kanayama, M.D., of the Hakodate Central General Hospital in Hokkaido, Japan, and colleagues analyzed data from 218 patients who underwent posterior L4 to L5 instrumented fusion or ligamentoplasty, with at least two years of follow-up. Of these participants, 78 had posterior lumbar interbody fusion (PLIF), 75 had posterolateral lumbar fusion (PLF), and 65 had ligamentoplasty.
Although differences were not significant, the researchers found that adjacent-segment morbidity occurred in 14.1 percent of PLIF cases, 13.3 percent of PLF cases, and 9.2 percent of ligamentoplasty cases. The time to adjacent-segment disease was 25.2 months for PLIF, 39.3 months for PLF, and 51.8 months with ligamentoplasty. Even though the difference was not significant, 7.6 percent of the PLIF group, 6.7 percent of the PLF group, and 1.5 percent of the ligamentoplasty group required additional surgery on adjacent segments.
"Prevalence of adjacent-segment morbidity and reoperation rate seemed to be lower in the posterior ligamentoplasty than fusion surgeries, but the difference was not significant. Posterior ligamentoplasty circumvented adjacent-segment disease for [a] longer period than fusion surgeries. Thus, ligamentoplasty favored reducing the risk of adjacent-segment deterioration and was effective as a time-saving procedure," the authors write.