Complications and surgical considerations in posterior lumbar interbody fusion with carbon fiber interbody cages and steffee pedicle screws and plates

Sixty consecutive patients undergoing posterior lumbar interbody fusion with a carbon fiber cage and posterolateral fusion using Steffee VSP (Depuy, Raynham, Mass) pedicle screw and plate instrumentation were reviewed. Perioperative complications, operative blood loss, and operative time were evaluated. Six dural tears, three transient sensory deficits, and two cases of deep venous thrombosis were reported. Operative blood loss for primary cases averaged 269 cc for one level and 569 cc for two levels fused. Patients with prior surgery averaged 378 cc for one level and 470 cc for two levels fused. Operative time for primary cases averaged 202 minutes for one level and 251 minutes for two levels fused. Patients with prior surgery required 208 minutes for one level and 251 minutes for two levels fused. Posterior lumbar interbody fusion with instrumented posterolateral fusion can be performed with a low intraoperative complication rate. Blood loss and operative time compare favorably with alternative methods of obtaining 360° fusion. Radiographic fusion was obtained in 100% of patients. Outcome analysis revealed 67% excellent or good results.