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.
Girardo
M
M
Department of Spine Surgery, CTO/CRF/Maria Adelaide, Via Zuretti 29, Turin 10126, Italy. massimogirardo@libero.it
Bettini
N
N
Dema
E
E
Cervellati
S
S
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