Adding Posterior Lumbar Interbody Fusion to Pedicle Screw Fixatin and Posterolateral Fusion after Decompression in Spondylolytic Spondylolisthesis
10.4055/jkoa.1995.30.6.1638
- Author:
Se Il SUK
;
Choon Ki LEE
;
Won Joong KIM
;
Hyung Gook KIM
- Publication Type:Original Article
- Keywords:
Spondylolytic Spondylolisthsis;
Posterior Lumbar Interbody Fusion (PLIF)
- MeSH:
Congenital Abnormalities;
Decompression;
Humans;
Pedicle Screws;
Recurrence;
Retrospective Studies;
Spinal Stenosis;
Spondylolisthesis
- From:The Journal of the Korean Orthopaedic Association
1995;30(6):1638-1646
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: This is a retrospective study analyzing 76 patients treated by decompression, pedicle screw instrumentatin and fusion for spondylolytic spondylolisthesis with symptomatic spinal stenosis. OBJECTIVES: This is to verify the advantages of adding posterior lumbar interbody fusion (PLIF) to the usual posterolateral fusion (PLF) with pedicle screw instrumentation. SUMMARY OF BACKGROUND DATA: Stabilization after decompression of spondylolytic spondy- lolisthsis is difficult due to insufficiency of fusion base, gap between the bases and incompetent anterior disc support. PLIF offers anterior support, reduction and a broad fusion base. METHODS: Forty patients were treated with PLF and 36 were treated with additional PLIF. They were compared for union, reductin of the deformity and clinical results. RESULTS: The patients were followed up for more than 2 years (mean: 4.6 years). Nonunion was observed in 3 PLF cases (7.5%) and none in PLIF. Reduction of slippage was 28.3% in PLF and 41.6% in PLIF (p < 0.05). In PLF group, 8 patients (20%) had recurrence of deformity with loss of reduction more than 50%. Hardware failures occurred in 2 with PLF. There was no major neurologic complications in both groups. Both groups had a few difference in the satisfactory results, but some difference in the excellent result by Kirkaldy-Willis criteria. Excellent result was 45% in PLF and 75% in PLIF. CONCLUSIONS: Addition of PLIF to PLF following a complete decompression and pedicle screw flxation is a recommendable procedure for the treatment of spondylolytic spondylolisthesis with spinal stenosis.
