Complications in spondylolisthesis surgery.
METHODS
Selected references are cited to illustrate the current status of approaches to surgical complications in isthmic spondylolisthesis surgery.


OBJECTIVE
To minimize untoward events and outcomes in the surgical treatment of spondylolisthesis, an awareness of complications and pitfalls specific to spondylolisthesis surgery is necessary.


BACKGROUND
Pseudarthrosis is the most common complication, and factors that contribute are vertebral geometry, bone grafting options and technique, and immobilization with instrumentation constructs or an orthosis. There has been an increase in neurologic deficits associated with spondylolisthesis surgery during the period of 1996 to 2002. Neurologic sequelae can include cauda equina syndrome, root lesions, autonomic dysfunction, and chronic pain. These can result from reduction maneuvers, instrumentation, and after surgery, although neurologic deficit can occur without identifiable causes. Restoring or maintaining the physiologic sagittal contour of the lumbar spine is a necessary component of surgical planning.


METHODS
Literature review.


RESULTS
Problems and complications associated with the surgical treatment of spondylolisthesis are well documented in the medical literature.


CONCLUSIONS
The occurrence of pseudarthrosis, neurologic deficits, and transition syndromes such as spondylolisthesis acquisita, S1-S2 deformity, and adjacent segment syndrome can be minimized with proper planning and attention to surgical technique.
Ogilvie
James W
JW
Shriners Hospital for Children, Intermountain Unit, Salt Lake City, UT 84105, USA. jwogilvie@msn.com
D006801:Humans; D009422:Nervous System Diseases / Q000209:etiology* / Q000601:surgery; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011542:Pseudarthrosis / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D013168:Spondylolisthesis / Q000601:surgery*