Uninstrumented posterolateral spinal arthrodesis: is it the gold standard technique for I degrees and II degrees grade spondylolisthesis in adolescence?
We retrospectively reviewed the outcome of uninstrumented posterolateral spinal arthrodesis in 49 patients with lumbar isthmic spondylolisthesis grades I degrees and II degrees in adolescent patients in the time of surgery, who participate at follow-up, between 1980 and 1995. The goal of our study is to analyse the clinical and radiographic imaging at long follow-up in uninstrumented posterolateral arthrodesis and to evaluate the efficiency and the validity of surgical technique in young patients (<18 years). All patients had failed previous conservative treatment. The average age at follow-up was 33.5 years (range 25-42 years) and the average follow-up time was 19.7 years (range 12-27 years). The clinical outcome measures were the Oswestry Disability Index, the SF-36, and the visual analogic score. All measures assessed the endpoint outcomes at 20 years after surgery. The outcome of spinal fusion was good with 43 (87.7%) patients attaining solid fusion, pseudoarthrosis in 6 patients (12.3%). None of our patients complained of excessive postoperative wound pain. Additionally, no complications, such as wound infection, were encountered. Satisfactory results were obtained in 94% 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.
Department of Spine Surgery, CTO/CRF/Maria Adelaide, Via Zuretti 29, Turin 10126, Italy. massimogirardo@libero.it
M
M
Girardo
N
N
Bettini
E
E
Dema
S
S
Cervellati
D000328:Adult; D000367:Age Factors; D000375:Aging / Q000502:physiology; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000254:growth & development / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010149:Postoperative Pain / Q000453:epidemiology; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D011859:Radiography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000379:methods* / Q000592:standards* / Q000706:statistics & numerical data; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology; D016896:Treatment Outcome