A comparison of single-level fusions with and without hardware.

During a 47-month period, 68 patients were studied prospectively to compare single-level lumbar fusion with and without adjunctive pedicular fixation. Fusion indications were disabling back pain for a minimum of 6 months, inability to work, and failed conservative care. Twenty-nine patients fused without hardware and 39 fused with VSP fixation in identical procedures. All patients were evaluated according to fusion success, perceived pain, and return to work. Pseudarthrosis was demonstrated in 58.6% of the noninstrumented group. No pseudarthroses were noted in instrumented patients. Pain improvement in the nonhardware group was 41.4%, and in the hardware group, 76.9%. Return to work was 31% and 72% in each group, respectively. The fusion rate for patients exhibiting single-level disc disease improves with spinal fixation.