A Novel Anatomical Closure Technique For PLIF: Improved Hemostasis, Reduced Drain Duration, and Enhanced Functional Outcomes

Objectives: This study introduces a novel anatomical closure technique in posterior lumbar interbody fusion (PLIF) surgery utilizing Adjustable Cross-Link (ACL) support to improve hemostasis, minimize drain duration, and enhance postoperative outcomes.
Methods: A retrospective analysis was conducted on 44 patients undergoing single-level PLIF with total laminectomy. Nineteen patients received standard closure (Group 1), while 25 underwent ACL-assisted closure (Group 2). Outcomes, including blood loss, drain usage, and functional recovery, were compared between the groups.
Results: Group 2 demonstrated significantly lower blood loss (p=0.044), reduced drain index (p<0.001), and shorter hospital stays (p<0.05) compared to Group 1. Early-stage visual analogue scale (VAS) for low back pain was also lower in Group 2 (p<0.001). Complication rates were lower in Group 2 (4.0% vs. 10.5%), with no reoperations required. Functional recovery, assessed by ODI scores, showed significant improvements in both groups.
Conclusion: ACL-assisted anatomical closure significantly reduces blood loss, shortens drain duration, and enhances early functional outcomes. Its mechanical stability facilitates better muscle healing and reduces postoperative complications, highlighting its potential as a superior closure method in PLIF surgeries.

Keywords: Contralateral radiculopathy, foraminal elevation, lordotic cage, PLIF (posterior lumbar interbody fusion), spinal stenosis