The reasons for this examination were to research the combination rate and clinical results of 2-level back lumbar interbody combination (PLIF). PLIF gives ideal clinical results and a high combination rate. Notwithstanding, most surviving examinations have been restricted to the consequences of single-level PLIF. Clinical results and combination pace of 2-level PLIF are obscure.

Altogether, 73 patients who went through 2-level PLIF underneath L3 somewhere in the range of 2008 and 2016 (subsequent period >2 y) were incorporated. Patients were partitioned into the 2 gatherings based on careful level. The lumbar gathering included 48 patients who went through L3/4/5 PLIF, and the lumbosacral gathering included 25 patients who went through L4/5/S PLIF. Combination rate and clinical results were analyzed. The Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and a visual simple scale were utilized for assessment.

Combination rate was fundamentally lower in the lumbosacral gathering (lumbar 96% versus lumbosacral 64%; P<0.001). Eight of 9 instances of pseudarthrosis happened at the lumbosacral portion. Improvement in the emotional well-being space of the JOAPEQ was fundamentally lower in the lumbosacral gathering (lumbar 16 versus lumbosacral 10; P=0.02). The VAS information demonstrated that enhancements in the accompanying factors were altogether lower in the lumbosacral gathering than in the lumbar gathering: torment in low back (lumbar −38 versus lumbosacral −23; P=0.004), torment in hindquarters or lower leg (lumbar −48 versus lumbosacral −29; P=0.04), and deadness in hindquarters or lower leg (lumbar −44 versus lumbosacral −33; P=0.04).

Hence it concludes that Two-level PLIF at the lumbosacral portion showed an essentially lower combination rate and more unfortunate clinical results than that at the lumbar-just fragments. Some fortification for the sacral anchor is prescribed to improve combination rate, in any event, for short combinations like 2-level PLIF, if the lumbosacral fragment is incorporated.

Ref: https://journals.lww.com/jspinaldisorders/Abstract/2020/12000/Two_level_Posterior_Lumbar_Interbody_Fusion_at_the.18.aspx