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The surgical technique was the same as described in a preliminary report and was not modified. 1. Clinical and radiological follow-up All patients were clinically and radiologically evaluated at the postoperative day 1, 6 months, 1, 3, and 5 years. VAS, and the Megestrol Acetate Prolo economical and functional scales used for clinical follow-up. Upright dynamic X-rays and lumbar vertebral CT with sagittal and coronal reconstruction were used for radiological follow-up. The quality of fusion was determined on the coronal reconstruction of lumbar vertebral CT and all paients were followed-up until fusion was present. Additionally, to detect any adjacent segment disease, non-contrast lumbar MRI was performed in the long-term follow-up. Results Twenty one (52.5%) female and 19 (47.5%) male patients were included in the study. Mean age was 43.5 years (range, 22�C57 years). The most common symptoms were back pain (89%), pelvic and leg pain (69%) and reduction in the walking distance (65%). A total of 180 pedicle screws were inserted in 40 patients; posterior lumbar interbody fusion (PLIF) and laminoplasty with reduction was performed in 20 patients for L4�CL5, in 12 patients for L5�CS1, in 4 patients for L3�CL4�CL5 and in 4 patients for L4�CL5�CS1. Ten (25%) patients with ISL had accompanying spinal stenosis. The difference between preoperative and postoperative sagittal plane dislocation and disc space height values were statistically significant in all patients (p in 38 patients; grade 2 pseudoarthrosis developed in 2 (5%) patients, UMI-77 ic50 but both were asymptomatic. The average duration of follow-up was 5.5 years. None of the patients had any motor deficit. Straight leg raising test was positive in 11 patients (27.5%). Hyporeflexia of the achille was detected in 6 (15%) patients. Preoperative clinical, economical and radiological findings are summarized in Table 1. In two cases, the anteriorly placed allograft worn out or pseudoarthrosis was present. These patients had no pain to support pseudoarthrosis clinically; fusion was radiologically insufficient but clinical success was achieved. Fusion was complete in all the other patients. Four patients were long-time smokers and smoked a pack of cigarettes per day. The fusion rate was 95% under these conditions. Table 1 Postoperative Nintedanib nmr rates of Prolo scores Preoperative and postoperative values of sagittal slipping and disc space heights are shown in Table 2. VAS values are shown in Table 3. The differences between preoperative and postoperative sagittal plane dislocation and disc space height values were statistically significant (p