Problems in Reduction of High-Grade Spondylolisthesis.
10.4184/jkss.2001.8.3.362
- Author:
Kee Yong HA
1
Author Information
1. Department of Orthopaedic Surgery, Kang-Nam St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea. kyh@cmc.cuk.ac.kr
- Publication Type:Review
- Keywords:
High-grade;
Spondylolisthesis;
Reduction;
Problem
- MeSH:
Back Pain;
Congenital Abnormalities;
Decision Making;
Humans;
Korea;
Research Personnel;
Spondylolisthesis*;
Traction
- From:Journal of Korean Society of Spine Surgery
2001;8(3):362-371
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
There has been discussion about surgical strategies for treatment of high-grade isthmic spondylolisthesis(grade III or IV). Reduction is combined unnecessary by many authors because of the reliability of in situ fusion. However, some investigator have stated a need for reduction is not only restoration of normal spinal alignment and biomechanics; A reduced position is believed to enhance fusion, relieve neurological abnormalities and pain, and improve the cosmetic appearance. Many different techniques have been developed for reduction of spondylolisthesis after Jenkin's initial description in 1936. The techniques include halofemoral traction, cast reduction, instrumentation, L5 corpectomy, and the combined anterior and posterior approach. Recently, newly developed pedicular instrumentation was widely used to reduce high-grade spondylolisthesis and had high fusion rates. But these instrumentations cannot prevent complications such as nerve root lesions due to the traction on the L5 root during reduction. Anyway, there is much controversy about the most effective surgical treatment option for highgrade isthmic spondylolisthesis. As well symptoms may vary depending the age of patient. Surgical decision making and preoperative planning need to address not only the anatomic deformity but also the symptoms complex as manifested by the predominance of either back pain and/or radicular symptoms. However, the patients with high-grade isthmic spondylolisthesis are very limited in Korea. Therefore, the best reliable reduction method for high-grade spondylolisthesis remains a challenging procedure, requiring great surgical attention to detail.
