title: Posterior reduction and anterior lumbar interbody fusion in symptomatic low-grade adult isthmic spondylolisthesis: short-term radiological and functional outcome.
abstract: The aim of this study was to evaluate the short-term radiological and functional outcome of surgical treatment for symptomatic, low-grade, adult isthmic spondylolisthesis. Twelve patients underwent a monosegmental fusion for symptomatic spondylolisthesis. Posterior reduction with pedicle screw instrumentation was followed by second-stage anterior interbody fusion with a cage. All patients underwent a decompressive laminectomy. At an average of 2.1 (range 1.4-3.0) years following surgery, all patients completed the Oswestry questionnaire, VAS back pain score and a questionnaire detailing their work status. Radiographs were evaluated for maintenance of reduction and fusion. The patients (nine male, three female; mean age 42, range 22-54 years) had experienced preoperative symptoms for an average of 38 (range 6-96) months. An average preoperative slip of 21% (range 11-36%) was reduced to 7% (range 0-17%). Reduction of slip was maintained at latest follow-up, at which time the average VAS score was 2.8 (range 0-8) and the average Oswestry score was 13 (range 0-32). All patients achieved a successful fusion. There were no postoperative nerve root deficits. All patients stated that they would be prepared to undergo the same procedure again if required. Seventy-five percent returned to their pre-symptom work status. Our findings suggest that posterior reduction and anterior fusion for low-grade adult isthmic spondylolisthesis may yield good functional short-term results. A high fusion rate and maintenance of reduction with a low complication rate may be expected. Further follow-up is necessary to evaluate long-term outcome.
authors.affiliation: Department of Orthopaedics, Sint Maartenskliniek, Nijmegen, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Spruit
authors.forename: P W
authors.initials: PW
authors.lastname: Pavlov
authors.forename: J
authors.initials: J
authors.lastname: Leitao
authors.forename: M
authors.initials: M
authors.lastname: De Kleuver
authors.forename: P G
authors.initials: PG
authors.lastname: Anderson
authors.forename: F
authors.initials: F
authors.lastname: Den Boer
mesh_terms: D000328:Adult; D001416:Back Pain / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001863:Bone Screws / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects / Q000706:statistics & numerical data*; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D011859:Radiography; D013123:Spinal Fusion / Q000009:adverse effects / Q000706:statistics & numerical data*; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome