Long-term Efficacy of GRAF Soft Fixation and PLIF with Cages in Multiple Spondylotic Stenosis in Lumbar Spine

Young–Soo Kim, MD
Dong–Kyu Chin, MD
Yong–Eun Cho, MD
Byung–Ho Jin, MD (Seoul, Korea)

Introduction:

As a treatment of multiple spondylotic stenosis in lumbar spine, there is no doubt about the role of wide laminectomy for neural decompression. But post–laminectomy instability caused by wide decompression may provide a delayed deterioration and further stabilization procedures should be performed. Among the various fusion techniques, pedicle screw fixation with rigid system can provide post–operative stability, but it may result in degenerative changes in adjacent segment and hardware failure. Therefore authors tried GRAF soft stabilization to avoid such complications. The purpose of this study is to evaluate the long–term efficacy of GRAF soft stabilization and PLIF with cages in achieving spinal fusion.

Methods:

Total 259 patients underwent GRAF soft stabilization and PLIF with cages during the last 7 years. Among them, 124 patients could be followed–up for more than 2 years and their clinical and radiographic data were reviewed retrospectively.

Results:

The clinical success according to Prolo's scale was achieved in 88.7% and bony fusion was achieved in 92.0%. The angular instability was improved from 14.9 degree to 3.4 degree and translational instability was decreased from 6.4 mm to 1.6 mm (P<0.001). The degenerative changes on adjacent segment were little.

Conclusion:

The GRAF soft stabilization and PLIF with cages has been found to be an effective and safe procedure for multiple spondylotic stenosis, in which wide decompressive laminectomy should be underwent. And this procedure may be more physiologic than rigid fixation and provide a high fusion rate and clinical success.