title: Comparison of posterior lumbar interbody fusion (PLIF) with autogenous bone chips and PLIF with cage for treatment of double-level isthmic spondylolisthesis.
abstract: BACKGROUND
  Spondylolytic defects involving multiple vertebral levels are rare. It is reported that only 1.48% of patients with back pain were diagnosed with multi-level spondylolysis. The incidence of multiple-level spondylolisthesis is even rarer, so far there have been few reports of multi-level isthmic spondylolisthesis in the literature. The aim of this study is to evaluate clinical and radiological outcomes of two different fusion techniques for treatment of double-level isthmic spondylolisthesis.
  
  
  METHODS
  Fifty-four patients who were managed surgically for treatment of double-level symptomatic isthmic spondylolisthesis were included in this study. Between May 2004 and September 2012, 29 consecutive patients underwent posterior lumbar interbody fusion (PLIF) with autogenous bone chips (group I) at Foshan Hospital of Traditional Chinese Medicine, Guangdong, China. Between March 2005 and December 2013, 25 consecutive patients underwent PLIF with cage (group II) at Zhujiang Hospital of Southern Medical University, Guangdong, China. The mean follow-up periods were 27.2 and 26.8 months, respectively.
  
  
  RESULTS
  The mean VAS scores of back and leg pain significantly decreased from 7.2 to 2.2 and 5.8 to 2.1 in the group I and from 7.0 to 1.9 and 6.1 to 1.8 in the group II, respectively. In the group I, mean ODI scores improved significantly from 54% to 14.2% and, in the group II, from 60% to 12.6%. In both groups, VAS and ODI scores significantly changed from pre- to postoperatively (p<0.001), but postoperative outcome between groups was statistically not significant. Solid union was observed in 27 of 29 patients (89.6%) in the group I and in 22 of 25 patients (88%) in the group II, without statistically significant differences (p>0.05). In both groups, changes in disc height, degree of listhesis, and whole lumbar lordosis between the pre- and postoperative periods were significant.
  
  
  CONCLUSIONS
  Clinical and functional outcomes demonstrate no significant differences between groups in treating back and leg pain of adult patients with double-level isthmic spondylolisthesis.
authors: Department of Spine Surgery, Foshan Hospital of Traditional Chinese Medicine, China. Electronic address: songdeyongss@126.com.
authors: Deyong
authors: D
authors: Song
authors: Department of Spine Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou City, Guangdong Province, China.
authors: Zhong
authors: Z
authors: Chen
authors: Department of Minimally Invasive Pain Treatment, Mengyin County Hospital, Linyi City, Shandong Province, China.
authors: Dewei
authors: D
authors: Song
authors: Department of Spine Surgery, Shilong Affiliated Hospital of Southern Medical University, Dongguan City, Guangdong Province, China.
authors: Zaixue
authors: Z
authors: Li
mesh_terms: D000328:Adult; D001416:Back Pain / Q000209:etiology; D001842:Bone and Bones; D002681:China; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008141:Lordosis / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008161:Lumbosacral Region / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011859:Radiography; D013123:Spinal Fusion / Q000379:methods*; D013168:Spondylolisthesis / Q000601:surgery*; D016896:Treatment Outcome
keywords: Autogenous bone chips; Comparison; Double-level isthmic spondylolisthesis; Instrumentation; Interbody fusion; Outcomes