Outcome of Posterior Lumbar Interbody Fusion for Degenerative Lumbar Spine Spondylolisthesis in a Neurosurgical Centre in Nigeria

Abstract

Introduction: Posterior lumbar interbody fusion (PLIF) is one of the options for the management of lumbar spine instability and is being
increasingly used in Nigeria. The aim of the study is to assess the outcome of cases managed with PLIF in Enugu, Nigeria.

Methods: Retrospective analysis of all patients that had PLIF for degenerative lumbar spine spondylolisthesis from the year 2016 to 2019 at a single centre the interbody fusion device was polyetheretherketone cage loaded with autologous bone graft. All patients presented with severe low back pain. Patients operated for traumatic spondylolisthesis and those managed with pedicle screw fixation alone were excluded. Patients were followed up for at least one year. The outcome was assessed using Japanese Orthopedic Association (JOA) scoring for back pain, visual analog score (VAS), fusion rate, and the 5‑point patient‑reported improvement scale.

Results: Atotal of 57 patients were analyzed. The mean age was 56.5 ± 7.4 years and the mean duration of back pain was three years (1–15 years). The mean preoperative VAS was 7.9 ± 1.1, while the postoperative VAS score was 3.3 ± 1.7. The JOA scores before surgery and at least 12 months post-surgery were 12.9 ± 2.8 and 22.9 ± 4.9, respectively. The patient recovery rate was 63.3%. A satisfactory outcome was noted in 82.8% of patients, post-surgery. The average fusion rate postsurgery was 88%. The most common postoperative complication was cerebrospinal fluid leak (8.8%). Four obese patients had implant‑related complications.

Conclusion: PLIF for degenerative spine disease is associated with significant improvement in preoperative back pain and neurological
outcome. It is also associated with good fusion, recovery, and patient‑reported improvement.

Keywords: Degenerative lumbar disc disease, Nigeria, outcome, posterior lumbar interbody fusion, visual analogue score and Japanese
Orthopedic Association