Interlaminar lumbar instrumented fusion (ILIFTM) in treatment of failed back surgery syndrome after first surgery

【Objective】To evaluate the clinical effects of local laminectomy and interlaminar lumbar instrumented fusion(ILIFTM) for failed back surgery syndrome(FBSS) of lumbar stability after first surgery.【Methods】From December 2009 to February 2011,17 patients with FBSS of lumbar stability after first surgery were treated with ILIFTM(GroupⅠ),average of duration time of reoperation from the first surgery 16 months(range,40 days~26 months).Total 24 segments were involved in ILIFTM,including L3~4 in 4 cases,L4~5 in 4 cases,L5,S1 in 3 cases,L3~4 and L4~5,double segments in 3 cases,L4~5 and,L5,S1,double segments in 3 cases.And retrospectively analyzed 21 patients(29 segments) with FBSS of Lumbar stability after first surgery were used inter-body fusion and percutaneous pedicle screw fixation after decompression(Group Ⅱ) from March 2006 to November 2009.The clinical outcomes were evaluated with surgical time,blood loss,and the pre-and post-operative Visual analog scale(VAS) scores,Oswestry Disability Index(ODI) scores were compared.【Results】 The patients were followed up for an average of 15.8 months(range,12~23).All the patients felt the low back pain and radiation pain disappeared or relieved apparently.The pre-and post-operative VAS scores and ODI of each group showed statistically significant improvement,but no statistical significance between the two groups.However,the surgical time,blood loss,have statistical difference between the two groups.The mean of cross-sectional area in Group Ⅰ significant wide from(58.75 ± 18.5) mm2to(102.15 ± 22.1) mm2.All patients achieved union or probable union at final follow-up.【Conclusion】 The ILIFTM promote fusion between the spinous processes to provide long-term spine stabilization,and provide a permanently protective cover for the spinal cord to help prevent scar tissue from pressing on the spinal cord and/or nerves.Compared with inter-body fusion,these procedures has less incision,simple method of fixation and fusion,less blood loss and maintain lumbar stability.