Clinical outcomes and considerations of the lumbar interbody fusion technique for lumbar disk disease in adolescents

Abstract

PURPOSE: The posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) techniques are commonly used surgical methods for wide indications such as degeneration or trauma. Although they are rarely required for lumbar disk disease in younger patients, there are a few children and adolescents who are indicated for PLIF or TLIF for other reasons, such as congenital severe stenosis with or without lumbar instability that requires wide decompression or severe bony spur that need to be removed. In such cases, different pathophysiology and outcomes are expected compared with adult patients. METHODS: We retrospectively reviewed data of 23 patients who underwent PLIF or TLIF surgery when less than 20 years old. Clinical and radiographic outcomes were assessed during a mean of 36.4 months follow-up period. The indications of lumbar interbody fusion, success of fusion, complications, and visual analog scale (VAS) were analyzed. RESULTS: Radiographs of all patients taken 6 months after the surgery showed fusion. Clinical outcome was also satisfactory, with improvement of VAS score from 7.7 preoperatively to 2.3 at 6 months after surgery. Only one patient had reoperation due to adjacent segment disease. CONCLUSIONS: For adolescent patients with severe bony spur, massive central disk rupture, or severe spondylolisthesis, lumbar interbody fusion surgery has good surgical outcome with few complications.