Complications associated with posterior lumbar interbody fusion using Bagby and Kuslich method for treatment of spondylolisthesis

Objective To analyze complications associated with posterior lumbar interbody fusion (PLIF ) in which two Bagby and Kuslich (BAK) interbody fusion cages were implanted. Methods A total of 118 patients with spondylolytic spondylolisthesis underwent single - l evel PLIF using two BAK cages filled with morselized autogenous bone. The major clinical and radiographic complications were analyzed after a follow - up with a n average time of 2 years and 9 months. Results Complications were divided into intraoperative and postoperative complications. Intraoperative complications mainly included dural tear (4 patients, 3.4%), ne rve root injury (3 patients, 2.5%) and suboptimal cage position (9 patients, 7 .5%). No death was caused by the operation. Postoperative complications chi efly consisted of cage retropulsion (3 patients, 2.5%), cage subsidence (4 pati ents, 3.4%), and postlaminectomy arachnoiditis (2 patients, 1.7%). Pseudarthr osis was noted radiographically with evidence of motion between adjacent ver tebra on lateral flexion - extension films and luciencies around the cages (2 pat ient, 1.7%), continuous posterior cage migration (2 patients, 1.7%) or continu ous cage subsidence (2 patients, 1.7%). Two patients died, one from a traffic accident and the other from metastatic cancer 1 year postoperatively. Conclusions The results of this study indicate that PLIF with BAK cages is an effective but also technically difficult procedure. The relatively high incidence of complica tions reminds us of the importance of surgical indications and proper manipulations.