[Posterior interbody fusion versus improved transforaminal lumbar interbody fusion in segmental spinal fixation for aged spondylolisthesis with lumbar spinal canal stenosis].
OBJECTIVE
To assess the clinical and radiographic outcomes of posterior lumbar fixation and posterior interbody fusion or improved transforaminal lumbar interbody fusion for Meyerding grade II/III spondylolisthesis so as to address the suitability of a dynamic stabilization.


METHODS
A total of 28 consecutive patients underwent posterior lumbar fixation and posterior interbody fusion or improved transforaminal lumbar interbody fusion for Meyerding grade II/III spondylolisthesis. Among them, 13 patients underwent posterior interface fusion (PLIF) and pedicle screw fixation. And improved transforaminal lumbar interbody fusion (ITLIF) and placement of the same system were performed in 15 patients. Their clinical, economic, functional, and radiographic data were recorded both pre- and postoperatively.


RESULTS
The average changes of economic and functional scores on the Prolo scale were 1.36 and 1.48 respectively. In patients with posterior interbody fusion; the average preoperative vertebral slippage was 46.9% (range: 25 - 75%) versus 14.6% (range: 15 - 25%) postoperatively. In patients with ITLIF, the average changes in economic and functional scores were 1.75 and 1.63 respectively. And the average preoperative vertebral slippage was 45.2% (range: 28 - 78%) compared with 26.3% (range: 14 - 28%) postoperatively. When two fusion techniques were compared, an overall superior reliability and resistance of systems was associated with the ITLIF procedure. But their clinical outcomes did not differ greatly (P > 0.05).


CONCLUSIONS
The application of a segmental pedicle screw fixation is both feasible and efficacious.
Department of Orthopedics, Xuzhou Central Hospital, Xuzhou 221009, China.
Chao
C
Ma
Ji-bin
JB
Wu
Meng
M
Zhao
Wei-xiang
WX
Dai
De-hui
DH
Wu
Zhao-hong
ZH
Wang
Jie
J
Feng
Chao
C
Liu
Qing-hua
QH
Zhao
Ji-wei
JW
Tian
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae; D008875:Middle Aged; D013123:Spinal Fusion / Q000379:methods; D013130:Spinal Stenosis / Q000150:complications / Q000601:surgery*; D013168:Spondylolisthesis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome