Results of L4-L5 disc excision alone versus disc excision and fusion.

We evaluated the results of 85 patients having L4-L5 disc excision (52 having disc excision alone, and 33 having disc excision and fusion) using the Smiley-Webster scale at an average follow-up of 7.3 years. Both groups (fusion and nonfusion) were comparable except that the nonfusion group had a significantly higher percentage of patients with a history of chronic back pain and degenerative changes on their initial radiographs. The fusion group had significantly better results compared with the nonfusion group (85% satisfactory results versus 39% satisfactory results). The most common cause of unsatisfactory results in the fusion group was pseudarthrosis (two) while progressive degenerative disc disease (18) and recurrent disc prolapse (eight) were the most common cause of unsatisfactory results in the nonfusion group. The overall reoperation rate was 9.4% (13.5% in the nonfusion group, and 3% in the fusion group.