Computed tomography- and fluoroscopy-guided percutaneous screw fixation of low-grade isthmic spondylolisthesis in adults: a new technique.
OBJECTIVE
To evaluate the feasibility of computed tomography (CT)- and fluoroscopy-guided percutaneous screw fixation for the treatment of low-grade isthmic spondylolisthesis in adults.


METHODS
Ten consecutive adult patients (four men and six women; mean age: 57.1 [range, 44-78 years]) were prospectively treated by percutaneous screw fixation for low-grade (six grade 1 and four grade 2) isthmic spondylolisthesis of L5. For each patient, two 4.0-mm Asnis III cannulated screws were placed to fix the pars interarticularis defects. All procedures were performed under local anaesthesia by using CT and fluoroscopy guidance. Post-operative outcome was assessed using the visual analogue scale and Oswestry Disability Index (ODI) scores.


RESULTS
The procedure time ranged from 45 to 60 min. The mean screw length was 27 mm (range, 24-32 mm). The VAS and ODI measurements ± SD decreased from 7.8 ± 0.9 preoperatively to 1.5 ± 1.1 at the last 2-year follow-up, and from 62.3 ± 17.2 to 15.1 ± 6.0, respectively (P < 0.001 in both cases). Neither slip progression nor screw failure was noted.


CONCLUSIONS
This feasibility study showed that CT- and fluoroscopy-guided percutaneous screw fixation could be a rapid, safe and effective method of treating low-grade isthmic spondylolisthesis.


CONCLUSIONS
CT- and fluoroscopy-guided percutaneous screw fixation of isthmic spondylolisthesis is feasible. It could become an effective method to treat low-grade isthmic spondylolisthesis. Percutaneous trans-isthmic screw fixation can be performed under local anaesthesia. This new technique can be performed as an outpatient procedure.
Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, 151, route Saint-Antoine de Ginestière, 06200, Nice, France. amorettinicolas@yahoo.fr
Nicolas
N
Amoretti
Laurent
L
Huwart
Olivier
O
Hauger
Patrick
P
Browaeys
Pierre-Yves
PY
Marcy
Yasir
Y
Nouri
Caroline
C
Ibba
Pascal
P
Boileau
D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D001863:Bone Screws; D004185:Disability Evaluation; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010147:Pain Measurement; D011446:Prospective Studies; D015641:Radiography, Interventional; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome