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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

Long-term outcomes of long level posterolateral fusion in lumbar degenerative disease: comparison of long level fusion versus short level fusion: a case control study

BMC Musculoskeletal Disorders > Ausgabe 1/2015
Jin Kyu Lee, Chul Woong Kim, Chang-Nam Kang
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

CNK performed surgery. JKL and CWK performed clinical and radiological analysis. CWK acquired the data and performed the statistical analysis. JKL and CNK designed this study and drafted the manuscript. JKL and CNK revised the manuscript. All authors read and approved the final manuscript.



We sought to evaluate the long-term outcomes of long-level instrumented posterolateral fusion (PLF) directly compared to those with short level instrumented PLF for degenerative spinal stenosis.


From 1987–2002, patients who underwent instrumented PLF with wide decompression for degenerative spinal stenosis were reviewed. A total of 295 patients were available for follow-up over 10 years (mean, 14 years). These patients were divided into Group 1 (fusion of 1 or 2 levels) and Group 2 (fusion of three or more levels). Clinical and radiological outcomes were evaluated.


On clinical outcomes, Group 1 showed better results than Group 2 based on the Katz’s Activities Daily Living index (p = 0.024), Kirkaldy-Willis criteria (p = 0.001) and the Korean version of the Oswestry disability index (p = 0.01). However, excellent and good outcome was noted in more than 64.5 % in Group 2. For radiological outcomes, overall fusion rate was higher in Group 1 compared with Group 2, but not significantly different (p = 0.35). However, the metal problems and surgical complications were more developed in Group 2 (p < 0.001). Although the radiologic changes on adjacent segments increased in accordance with the follow-up period, particularly in Group 2 (p < 0.001), no correlation with clinical symptoms was found.


The long-level fusion group maintained acceptable clinical and radiological outcomes compared to the short-level fusion group at minimum of 10 years of follow-up.
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