Radiographic and Clinical Outcomes of Posterior Interbody Fusion for High-Grade Spondylolisthesis.
10.4184/jkss.2016.23.2.93
- Author:
Jae Yoon CHUNG
1
;
Hyoung Yeon SEO
;
Sung Kyu KIM
Author Information
1. Department of Orthopaedic Surgery, Chonnam National University Hospital, Gwangju, Korea. bonjourksk@hanmail.net
- Publication Type:Original Article
- Keywords:
High-grade spondylolisthesis;
Reduction;
Posterior interbody fusion
- MeSH:
Animals;
Decompression;
Female;
Follow-Up Studies;
Humans;
Kyphosis;
Lordosis;
Methods;
Pedicle Screws;
Retrospective Studies;
Spondylolisthesis*
- From:Journal of Korean Society of Spine Surgery
2016;23(2):93-99
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: Retrospective study. OBJECTIVES: To evaluate the clinical and radiological outcomes of posterior interbody fusion using pedicle screw fixation after posterior decompression for high-grade spondylolisthesis. SUMMARY OF LITERATURE REVIEW: The surgical treatment of high-grade spondylolisthesis has been controversial. However, few reports on the results of reduction and posterior interbody fusion after posterior decompression have been published. MATERIALS AND METHODS: Thirteen patients with L5-S1 high-grade spondylolisthesis (Meyerding grade III, IV) who underwent reduction and posterior interbody fusion were analyzed with at least 2 years of follow-up. The mean age of the patients (male 2, female 11) was 51 years. Classified by the type of spondylolisthesis, 10 cases were isthmic, 2 cases dysplastic, and 1 case degenerative. A visual analogue scale (VAS), the Oswestry Disability Index (ODI) score, bone union, anterior slippage, and slip angle were used in comparing clinical and radiographic outcomes. RESULTS: All cases showed improvement of preoperative symptoms. The VAS and ODI score improved from a mean of 8.9 points and 36.2 points preoperatively to 2.1 points and 10.2 points, respectively, at last follow-up. The degree of anterior slippage measured by Taillard's method was improved from a mean of 57.7% before surgery to mean of 14.6% at last follow-up. The slip angle also changed from a mean of 2.4° kyphosis before surgery to a mean of 7.6°C lordosis at last follow-up. There were two complications: infection and new radiating pain. CONCLUSIONS: Reduction and posterior interbody fusion using pedicle screw fixation after posterior decompression was a useful surgical method for high-grade spondylolisthesis that corrected lumbosacral kyphosis, filled the structural space of the anterior column, and acheived fusion of interbody movement.
