Posterior lumbar interbody fusion: A retrospective study of complications after facet joint excision and pedicle screw fixation in 148 cases

Abstract

We retrospectively evaluated neurological and other complications related to posterior lumbar interbody fusion (PLIF) performed by facet joint excision and pedicle screw fixation, in 148 consecutive patients with degenerative disorders. Their mean age at surgery was 59 (19-80) years. The mean follow-up period was 3 (2-6.5) years. Overall, 91 complications in 75 cases were observed. Although no permanent neural damage was detected, transient neural palsy occurred in 8% of the cases. Dural tear, partial misplacement, loosening, breakage of the pedicle screw and loss of correction were seen in 6, 6,4,1 and 1 of the cases, respectively. Deep infection of the fused segment developed in 2 cases. We conclude that PLIF, performed by facet joint excision and pedicle screw fixation, demonstrated a very low incidence of osteosynthesis failure, such as screw loosening, breakage and loss of correction. However, the high incidence of other complications, particularly neurological impairment, is still a disadvantage of this technically-demanding procedure.