Anterior lumbar interbody fusion combined with percutaneous pedicle screw fixation for degenerative lumbar instability: minimum four-year follow-up

Our goal was to investigate the long-term results of anterior lumbar interbody fusion combined with percutaneous pedicle screw fixation for degenerative lumbar instability. Forty-seven patients that had undergone anterior lumbar interbody fusion combined with percutaneous pedicle screw fixation for degenerative lumbar instability at Tianjin Hospital between May 2003 and January 2007 were reviewed retrospectively. Radiographic results including the fusion rate, disc space height, segmental lordosis and whole lumbar lordosis were analyzed, and clinical outcomes were assessed using the Japanese Orthopaedic Association score. In 47 patients, no surgery-related neurological deficit or wound breakdown was observed and 45 patients obtained a solid fusion. The mean JOA score increased significantly (p < 0.05) from 9.4 before surgery to 24.6 six months after surgery and 26.1 at final follow-up. The disc space height, segmental lordosis and whole lumbar lordosis increased significantly from pre-operative values to both six months postoperatively (p < 0.05) and at the final follow up (p < 0.05). Radiographic evidence of adjacent segmental degeneration was found in 14 patients (29.8%) and symptomatic adjacent segmental disease developed in 1 patient (2.1%). Anterior lumbar interbody fusion combined with percutaneous pedicle screws fixation in patients with degenerative lumbar instability results in good clinical and radiographic outcomes at long-term follow-up.