Title: Evaluation the effectiveness of discectomy with instrumented posterior lumbar interbody fusion (PLIF)


The aim of the presented study was to evaluate the effectiveness of discectomy with instrumented posterior lumbar interbody fusion (PLIF). Following questions were posed:1. What are the long term biomechanical effects of instrumented PLIF in patients with lumbar discopathy?2. What is the long term quality of life of patients with lumbar discopathy treated with instrumented PLIF?3. What are the results of nonoperative treatment of lumbar discopathy and what do they depend on?4. Is there a correlation between radiologic degenerative changes and the severity of pain?5. Which of the presented methods of treatment leads to a better long term outcome?The study was conducted basing on the material from University Hospital in Zakopane and comprised 140 patients – 68 men (that is 49%) and 72 women (51%). Age distribution was from 23 to 79 years (mean 52+/-13). There were no statistical differences between age, sex and type of treatment. Patients were divided in two groups: I – treated surgically, II – treated nonoperatively.Methodology included clinical, radiologic and subjective evaluation. Above that patients’ quality of life was assessed.Radiologic evaluation included analysis of lumbar spine ap and lateral films, preoperatively, immediately postoperatively and at final follow-up. Pre- and ; postoperative computer tomography and magnetic resonance images were also analysed. Following radiologic parameters were measured: angle of lumbar lordosis, motion segment angle, sacral anteversion angle, Ferguson angle, disc height, grade of anterior or posterior slippage, pelvic incidence (PI), global spine misalignment, grade of degeneration using Ghiselli scale, central and foraminal stenosis, finally Modic changes. Subjective evaluation was based on own questionnaire “Quality of life of patients with lumbar discopathy” that was handled to all patients. Above that Jackson scale was utilized to grade patients’ quality of life.Obtained results were analyzed statistically using following software: Statistica ver.7.1 (StatSoft), Microsoft Excel 2000 and 2007. Empirical distribution of features, t-Student test for related and non-related variables, variance analysis ANOVA, U Mann-Withney`s test, Wilcoxon`s test, independence test 2, ANOVA rang Kruskal-Wallis test, ANOVA Friedman`s test, Pearson`s correlation factor (rp), Spearman`s test and log-line analysis were used.Following conclusions can be made based on achieved results:1. Instrumented PLIF for lumbar discopathy leads only to a minor increase of lumbar lordosis.2. The quality of life of patients with lumbar discopathy treated with instrumented PLIF is significantly increased.3. Nonoperative treatment of lumber discopathy yields good long term outcome. The outcome correlates with the severity of initial symptoms.4. In patients with lumbar discopathy there is a low correlation between the radiologic degenerative changes and the intensity of pain.5. Long term outcome of treatment of lumbar discopathy are better in surgically treated patients compared with non-operatively treated patients.

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2 - studia doktoranckie

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Wydział Lekarski. Uniwersytet Jagielloński. Collegium Medicum.


Maciej Tęsiorowski

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Biblioteka Medyczna Uniwersytetu Jagiellońskiego- Collegium Medicum

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May 24, 2021

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May 12, 2015

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Edition name Date
ZB-122588 May 24, 2021


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