Outcome of Posterior Lumbar Interbody Fusion in Spondylolisthesis with Cage and Bone Graft

Open Access

Abstract

Background: Spondylolisthesis is a common cause of low back pain and neurological symptoms, with approximately 10-15% of patients requiring surgical intervention after failure of conservative treatment. Posterior lumbar interbody fusion (PLIF) with cage and bone graft is a well-established technique that provides spinal stability, high fusion rates, and satisfactory clinical outcomes in appropriately selected patients. Objective: The aim of the study was to evaluate the clinical, radiological, and functional outcomes of posterior lumbar interbody fusion with cage and bone graft in patients with spondylolisthesis. Methods & Materials: This prospective interventional study was conducted in the Department of Orthopaedic Surgery, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, from January 2019 to December 2020. Twenty patients with clinical and radiological spondylolisthesis were included based on predefined criteria. Outcomes assessed included VAS, ODI, MRC grading, Modified Macnab criteria, Hackenberg fusion status, and complications. Patients underwent standard surgical management and were followed for at least 6 months. Data were analyzed using SPSS version 26, with paired t-test applied (p < 0.05). Results: Among the 20 patients, the mean age was 42.80 ± 12.10 years, and 12 (60.0%) were female. Significant postoperative improvements were observed in VAS scores, ODI, and motor function, with motor deficits decreasing from 9 (45.0%) to 2 (10.0%). Solid fusion was achieved in 18 (90.0%) patients, superficial surgical site infection occurred in 3 (15.0%), and no cases of pseudarthrosis or implant failure were observed. According to the Modified Macnab criteria, 16 (80.0%) patients had excellent and 4 (20.0%) had good functional outcomes. Conclusion: Posterior lumbar interbody fusion with cage and bone graft is a safe and effective surgical technique that provides significant pain relief, neurological and functional improvement, a high fusion rate, and satisfactory clinical outcomes in patients with spondylolisthesis.