Posterior Lumbar Element Enforcement by Decompression Alone with Interspinous Fixation without Interbody Fusion for the Surgical Management of Lumbar Spondylolisthesis
- Author:
Hyun-Woong PARK
1
;
Moon-Soo HAN
;
Ji-Ho JUNG
;
Jong-Hwan HONG
;
Shin-Seok LEE
;
Jung-Kil LEE
Author Information
- Publication Type:Clinical Article
- From:Journal of Korean Neurosurgical Society 2025;68(2):150-158
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:: In degenerative lumbar spondylolisthesis, interbody fusion surgery (IFS) has long been recommended as the gold standard of surgical management. However, IFS is less recommended for high-risk patients such as the elderly because it involves extensive surgery, with a long operation time and high volumes of blood loss, which lead to marked perioperative morbidity. We report an alternative primary and salvage treatment technique for high-risk lumbar spondylolisthesis through posterior lumbar element reinforcement using interspinous fixation and decompression alone without interbody fusion.
Methods:: Plain radiographs, computed tomography scans, and magnetic resonance imaging, taken at different intervals, were used to measure local disc height (DH), vertebral body slippage (BS), and segmental motion angle (SMA). A Visual analogue scale and the Oswestry disability index (ODI) were applied pre-operation and at the last follow-up.
Results:: The local SMA decreased significantly by 3.46°±3.07°, from 10.61°±3.42° preoperatively to 7.15±3.70 at the last follow-up (p<0.001). The DH decreased from 8.61±2.88 mm preoperatively to 8.41±2.48 mm at the last follow-up (p=0.074). The BS decreased from 3.49±4.29 mm preoperatively to 3.41±4.91 mm at the last follow-up (p=0.092). None of the patients reported worsening pain or an increased ODI after surgery, and there were no surgery-related complications.
Conclusion:: Posterior lumbar element reinforcement by decompression alone with SPIRE™ fixation is an alternative primary and salvage treatment option for select patients with spondylolisthesis.
