Outcome of Two Fusion Methods In Isthmic and Degenerative Spondylolisthesis of the Lumbar Spine.
10.4184/jkss.2002.9.4.313
- Author:
Kyu Yeol LEE
1
;
Sung Keun SOHN
;
Sung Wan KIM
;
Sung Won LEE
Author Information
1. Department of Orthopaedic Surgery, College of Medicine, Dong-A University, Busan, Korea. gylee@mail.donga.ac.kr
- Publication Type:Original Article
- Keywords:
Spondylolisthesis;
Isthmic;
Degenerative;
PLF;
PLIF
- MeSH:
Humans;
Retrospective Studies;
Spine*;
Spondylolisthesis*
- From:Journal of Korean Society of Spine Surgery
2002;9(4):313-321
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
DESIGN: A retrospective study was performed in isthmic and degenerative spondylolisthesis patients who had undergone posterolateral fusion (PLF) only (group I) or posterolateral fusion (PLF) with posterior lumbar interbody fusion (PLIF) (group II). OBJECTIVES: The objective of this study was to help in the selection of a surgical treatment option for spondylolisthesis. SUMMARY OF LITERATURE REVIEW: Irrespective of whether group Ior group II, satisfactory results have been reported in the surgical treatment of spondylolisthesis. However, isthmic and degenerative types have not been investigated in terms of outcome. MATERIALS AND METHODS: We analyzed 112 patients (Isthmic: group I(32), group II(22), Degenerative: group I(37), group II(21)) who underwent surgical treatment for spondylolisthesis between April 1995 and December 2000. Kirkaldy-Willis criteria, radiologic union state, reduction ratio of slippage, change of disc space and change of segmental angle were analyzed as indicators of outcome. RESULTS: We found the following by radiologic analysis: In isthmic spondylolisthesis, group IIwas better than group Iin terms of reduction ratio of slippage (reduction loss:3.38% vs. 2.3%, P=0.15), change of segmental angle (reduction loss : 2.11 degrees vs. 1.6degrees, P=0.15), bone union (83% vs. 92%, P=0.45) and change of disc space (reduction loss : 2.83 mm vs. 1.9 mm, P=0.02). In the degen-erative spondylolisthesis, group IIdid not show significant difference from group Iin terms of reduced slippage (reduction loss: 3.8% vs. 3.85%, P=0.47), change of segmental angle (reduction loss: 2.73 degrees vs. 2.64 degrees, P=0.43), bone union (80% vs. 87%, P=0.72) or disc height (reduction loss: 3.2 mm vs. 3.14 mm, P=0.45). In terms of clinical outcome, group II was better than groups Iin cases of isthmic spondylolisthesis (fair < or =:85% vs. 93%, P=0.72), however, groups IIwas not better than groups Iin cases of degenerative spondylolisthesis (fair < or =:83% vs. 85%, P=0.23). CONCLUSIONS: In the degenerative spondylolisthesis patient, no significant difference was found between group Iand group II, but in the isthmic spondylolisthesis patient, group I and group II were found to be significantly different in terms of the reduction ratio of the disc heights.
