title: Results of lumbosacral distraction spondylodesis for the treatment of spondylolisthesis, failed-back syndrome, and lumbar instability.
abstract: Various methods of lumbosacral fusions for the treatment of degenerative spinal diseases are used clinically. Results vary greatly depending on indication, type of fusion, implants, and method of evaluation. In a retrospective clinical and radiological examination after an average follow-up time of 3.9 years this study reports on the outcome of lumbosacral distraction spondylodesis (LSDS) in a consecutive series of 147 patients being fused for the treatment of spondylolisthesis, failed-back syndrome, or lumbar instability. LSDS consists of a posterolateral fusion together with an autologous corticocancellous H-graft wedged under distraction between the spinous processes of L4 and S1. With 81.0% good and excellent results this noninstrumented fusion technique showed the best outcome in patients with spondylolisthesis, while in cases with a failed-back syndrome or lumbar instability only 62.3% excellent to satisfying outcomes were noted. The rate of pseudarthrosis was 13.6% in the whole patient group; no major complications such as nerve root damage, postoperative neurological deficits, or spinal stenosis were found.
authors.affiliation: Department of Orthopaedic Surgery, Wayne State University, Detroit, USA.
authors.forename: J
authors.initials: J
authors.lastname: Möller
authors.forename: R H
authors.initials: RH
authors.lastname: Wittenberg
authors.forename: L P
authors.initials: LP
authors.lastname: Nolte
authors.forename: M
authors.initials: M
authors.lastname: Jergas
authors.forename: R
authors.initials: R
authors.lastname: Willburger
authors.forename: J
authors.initials: J
authors.lastname: Krämer
mesh_terms: D055111:Failed Back Surgery Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D012447:Sacrum / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome