In situ instrumented posterolateral fusion without decompression in symptomatic low-grade isthmic spondylolisthesis in adults.
Forty patients with an average age of 26.5 years were treated for symptomatic low-grade isthmic spondylolisthesis with in situ instrumented posterolateral fusion. All patients had failed previous conservative treatment. Average follow-up was 42.2 months (range: 30-62 months). Low-back pain resolved in 70% of the patients, whereas 65% of those with radicular pain reported complete resolution of the symptoms. At the final follow-up 82.5% of the patients had improvement in their function. Solid fusion was achieved in 70% of the patients. It was uncertain in 10% and a fusion failure was seen in 20%. The anterior slippage as measured by the Taillard method was 31.55% and an average 35% correction was seen after surgery. However, an average 10% loss of correction was seen at the final evaluation. The clinical results were evaluated by Kim and Kim criteria. Satisfactory results were obtained in 65% of patients and this was closely associated with the rate of successful fusion. The results suggest that clinical outcome is closely related to the attainment of solid fusion and decompression or removal of the loose laminar fragment seems unnecessary in patients without major neurological symptoms.
Butt
Mohammed Farooq
MF
Government Hospital for Bone and Joint Surgery, Barzallah, Srinagar, Kashmir, India. mfbutt72@yahoo.co.in
Dhar
Shabir Ahmed
SA
Hakeem
Imtiyaz
I
Farooq
Munir
M
Halwai
Manzoor Ahmed
MA
Mir
Mohammad Ramzan
MR
Kangu
Khursheed Ahmed
KA
D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D019299:Decompression, Surgical; D006801:Humans; D011475:Prosthesis Failure; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D013168:Spondylolisthesis / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult