A critique of posterior lumbar interbody fusion: 12 years' experience with 250 patients.

A comprehensive long-term follow-up analysis of the clinical and radiographic results of posterior lumbar interbody fusion for lumbar disk disease is presented. This 12-year experience with 250 patients is compared with a previous critique of our surgical management of lumbar disk disease by laminotomy and diskectomy alone. The clinical results and complications rates are comparable. However, posterior lumbar interbody fusion significantly reduces the rate of recurrent problems requiring subsequent surgery. Careful technique and judgment are mandatory for success with posterior lumbar interbody fusion. Homologous tissue bank bone grafts were found to be as successful as autogenous bone. Posterior lumbar interbody fusion represents an improvement in the surgical management of lumbar disk disease.