200 A Retrospective Study of Thoracolumbar Burst Fractures Treated with Fixation and Non-fusion Surgery of Intra-vertebral Bone Graft Assisted with Balloon Kyphoplasty

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 254-254
Author(s):  
Chengmin Zhang ◽  
Paul M Arnold ◽  
Qiang Zhou
Keyword(s):  
Retrospective Study ◽  
Bone Graft ◽  
Balloon Kyphoplasty ◽  
Posterior Fixation ◽  
X Rays ◽  
Vertebral Height ◽  
Fusion Surgery ◽  
Vertebral Bone ◽  
Group A ◽  
Group B

Abstract INTRODUCTION horacolumbar fractures are common spinal injuries. Posterior fixation and fusion is the primary treatment, although this may sacrifice range of motion (ROM) to achieve stability, rather than treating the fracture itself. Two issues addressed when treating thoracolumbar fractures include: 1) replacing the fractured vertebrae, especially the upper endplate of the injured vertebrae, and 2) provide strong fixation with biomechanical stability and flexibility. METHODS This retrospective study included 75 consecutive patients with thoracic or lumbar fractures treated from October 2010 to May 2014. A total of 61 patients met inclusion criteria. Patients were divided into one of two groups: group A, intra-vertebral bone graft with balloon kyphoplasty (non-fusion surgery); and group B, traditional posterior fixation and fusion surgery. The Visual Analog Scale (VAS) was done preoperatively as well as at three months, one year, and two years. X-ray, CT, and MRI were done preoperatively. X-rays were done postoperatively at three months and two years. Postoperatively at 3 months, CT was used to confirm healing of the vertebral fracture. RESULTS >Patient demographics and baseline characteristics were similar in the two groups. All fractures in both groups were reduced successfully, deformity was improved, and the anterior vertebral height restoration (AHR) was 98.76% ± 3.78% of PDS group and 95.38% ± 5.07% of Fusion group. After removal of hardware in group A, ROM at the injury level recovered (mean ROM 8.57°), and at 2 years, there was no loss of vertebral height or recurrence of deformity. There was no hardware failure in group A, but there was evidence of screw loosening three screws in group B. CONCLUSION Non-fusion treatment of intra-vertebral bone graft assisted with balloon kyphoplasty demonstrated good fracture reduction, deformity correction, fracture healing, and ROM maintenance. There were no complications associated with the implant. With the continued development of surgical techniques and materials, we believe that an increasing number of spinal fracture patients can avoid spinal fusion.

scholarly journals Uniplanar cannulated pedicle screws in the correction of Lenke type 1 adolescent idiopathic scoliosis (AIS)

2020 ◽  
Author(s):  
Yiwei Zhao ◽  
Wubo Liu ◽  
Suomao Yuan ◽  
Yonghao Tian ◽  
Xinyu Liu
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Pedicle Screws ◽  
Vertebral Rotation ◽  
Concave Side ◽  
Convex Side ◽  
X Rays ◽  
Group A ◽  
Group B

Abstract Background In the present study, we reported the clinical use of uniplanar cannulated pedicle screws for the correction of Lenke type 1 adolescent Idiopathic scoliosis (AIS), and its safety and clinical outcomes were also evaluated. Methods 68 patients with Lenke type 1 AIS were included, among which 38 patients were treated with uniplanar cannulated screws at the concave side of periapical levels and multiaxial screws at the other levels (group A). Moreover, the remaining 30 patients were treated with all multiaxial screws (group B). The preoperative and postoperative radiographic parameters of the Lenke type 1 AIS, axial vertebral rotation, and the safety of the pedicle screws were evaluated by X-rays and computed tomography (CT). Results Preoperative data was comparable between two groups. The postoperative proximal thoracic (PT) curve, main thoracic (MT) curve, thoracolumbar/lumbar (TL/L) curve, and apical vertebral rotation were significantly improved compared with the preoperative data. The coronal correction rates in group A and B were 83% and 81.9%, respectively (P > 0.05). The derotation rates in group A and B were 60.8% and 43.2%, respectively (P < 0.05). The rotation classification in the group A was also better compared with the group B. The misplacement rate in group A and B was 7.9% and 11.8%, respectively (P < 0.05), and the total misplacement rate on the concave side (11.4%) was higher than that of convex side (8.4%). The lateral perforation was found at the concave side, while the medial perforation was found at the convex side. On the concave side, the misplacement rate in group A and B was 9.7% and 12.3%, respectively (P < 0.05). The grades 2 and 3 perforations were three (3.5%) in the group A and eight (8.2%) in the group B (P < 0.05). On the convex side, the misplacement rate in group A and B was 5.9% and 11.1%, respectively (P < 0.05). The grades 2 and 3 perforations were one (0.9%) in the group A and four (4.4%) in the group B (P < 0.05). Conclusion Collectively, uniplanar cannulated pedicle screws could effectively increase the accuracy of pedicle screws and facilitate the derotation of the apical vertebra compared with the multiaxial pedicle screws. Trial registration retrospectively registered

Do we need 30 min cortisol measurement in the short synacthen test: a retrospective study

2019 ◽  
Vol 96 (1138) ◽  
pp. 467-472
Author(s):  
Rajeev Kumar ◽  
Peter Carr ◽  
Kimberley Moore ◽  
Zeeshan Rajput ◽  
Louise Ward ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Adrenal Insufficiency ◽  
Late Response ◽  
Inadequate Response ◽  
Insufficient Response ◽  
Group A ◽  
Synacthen Test ◽  
Cortisol Levels ◽  
Group B ◽  
Short Synacthen Test

ObjectiveThe short synacthen test (SST) is widely used across the UK to assess adrenal reserve but there remains no consensus on the timing of cortisol sampling to help diagnose adrenal insufficiency. The main objective of our study was to see if both 30 and 60 min sample are required following administration of synacthen to investigate suspected adrenal insufficiency (AI).DesignThis was a single-centre retrospective study of 393 SSTs measuring 0, 30 and 60 min cortisol levels after administration of 250 µg of synacthen.Patients and methodsAll the SSTs for patients suspected of primary or secondary AI between April 2016 and October 2018 were included in this study. The tests were performed as per our hospital protocol. A post-adrenocorticotropic hormone (ACTH) cortisol response of 420 nmol/L at any time point was considered adequate to rule out AI. The data were analysed to ascertain the proportion of patients who achieved this level at 30 and/or 60 min.ResultsA total of 393 SST results were included in this study. Patients were divided into two groups depending on whether (group A) or not (group B) they were on steroids. Overall, a total of 313 (79.6%) subjects achieved cortisol level of ≥420 nmol/L at 30 and 60 min while 19 (4.8%) had late response (ie, insufficient 30 min cortisol levels, rising to ≥420 nmol/L at 60 min). Another 61 subjects (15.5%) showed insufficient response at both 30 and 60 min (ie, failed to achieved level of ≥420 nmol/L). Importantly, there was no patient in either group who had adequate response at 30 min and then failed at 60 min. Patients in group A were more likely to have inadequate response at both 30 and 60 min while patients in group B were more likely to have normal response at both time points.ConclusionsOur results suggest that about 5% of people undergoing SST may be inappropriately diagnosed as having AI (and subjected to long-term unnecessary steroid treatment) if the 60 min sample is not maintained. We suggest that 30 min sample does not add any additional diagnostic utility and can be omitted thus simplifying SST even further and saving on cost and resources. We propose that single measurement after 60 min of administration of synthetic ACTH is a sufficient screening test for AI.

scholarly journals Postural drainage in intubated patients with acute lobar atelectasis - A pilot study

2000 ◽  
Vol 56 (3) ◽  
pp. 29-32 ◽  
Author(s):  
M. W. Krause ◽  
H. Van Aswegen ◽  
E. H. De Wet ◽  
G. Joubert
Keyword(s):  
Intensive Care ◽  
X Rays ◽  
Average Group ◽  
Postural Drainage ◽  
Group A ◽  
Chest X Ray ◽  
Group B ◽  
Comparison Of Effectiveness ◽  
Clinical Experiment

Objectives: The movement and mobilisation of an intubated patient in the intensive care unit is restricted by the presence of various drains and intravenous lines. Difficulty to position the patient in the correct postural drainage positions, often leads physiotherapists to using modified postural drainage positions to mobilise secretions. A comparison of effectiveness between the correct postural drainage positions and the modified postural drainage positions during the treatment of acute lobar atelectasis in the intubated patient was conducted. Subjects: Intubated men and women between the ages of 13 and 85 years in the intensive care units of Pelonomi and Universitas Hospitals in Bloemfontein diagnosed with acute lobar atelectasis of the lower lobes were considered for inclusion in this pilot study.Intervention: A controlled randomised clinical experiment was conducted. Group A received inhalation therapywhilst placed in a postural drainage position for 15 minutes. Thereafter percussion was done for five minutes followed by a sterile suction procedure. Group B received the same treatment but modified postural drainage positions were used. Both groups received treatment twice daily.Results: On average, group A required three treatments and nil follow-up chest X-rays before the collapse was resolved, as opposed to the average of 4.5 treatments and one follow-up chest X-ray required by group B before the same result was obtained. In group A the oxygenation compared to Group B was improved. The findings were not statistically significant.Conclusion: The use of postural drainage positions in intensive care suggests quicker resolution of acute lobar atelectasis and improves oxygenation.

scholarly journals Patient-Perceived Quality of Life after Total Hip Arthroplasty: Elective versus Traumatological Surgery

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Alessandro Aprato ◽  
Alessandro Massè ◽  
Francesco Caranzano ◽  
Renato Matteotti ◽  
Patrick Pautasso ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Womac Score ◽  
X Rays ◽  
Length Discrepancy ◽  
Neck Fracture ◽  
Group A ◽  
Group B

Purpose. The aim was to evaluate and compare patient's health-related quality of life after THA for osteoarthritis and femoral neck fracture. The postoperative outcome was retrospectively evaluated in patients who underwent THA with an intracapsular femoral neck fracture (Group A) or with an hip osteoarthritis (Group B). Methods. Length discrepancy was measured on postoperative X-rays. Study groups were compared as to age, results of WOMAC and SF-36 tests, limb length discrepancy (LLD) by independent group t-test. Correlations between LLD and results obtained atWOMAC test were performed. 117 patients were enrolled. The 2 groups were similar as to age, type of implanted stem and sex. Mean follow up was 2,4 years for group A and 2,3 years for group B. Results. WOMAC score was found higher in group A in all items examinated. Correlation tests did not indicate a statistically significant linear relationship between LLD and WOMAC score in both groups. Conclusions. Patients who received THA for arthritis have better perception of quality of life than traumatologic patients. Although LLD should always be strongly considered by the surgeons performing a THA, LLD alone can't be considered as an indicator of patient dissatisfaction or clinical bad result after a 2-year followup.

scholarly journals Endodontic Irrigants and Their Activation Efficacy on Cleansing Post-Space Root Canal Walls

Prosthesis ◽  
2021 ◽  
Vol 3 (4) ◽  
pp. 406-414
Author(s):  
Manuela Marchese ◽  
Pontoriero I. K. Denise ◽  
Edoardo Ferrari Cagidiaco ◽  
Alfredo Iandolo ◽  
Simone Grandini ◽  
...  
Keyword(s):  
Root Canal ◽  
Continuous Wave ◽  
Smear Layer ◽  
The Other ◽  
X Rays ◽  
Ultrasonic Activation ◽  
Gutta Percha ◽  
Bonding System ◽  
Group A ◽  
Group B

The aim of this study was to evaluate the efficacy of activated irrigants (EDTA e NaOCL) during the cleansing of root walls, of the smear layer, of the debris, and gutta-percha after the preparation of the restorative space. Twenty single and multi-rooted (n = 20) have been collected. All samples were prepared by the same operator, using Nickel-titanium rotating instruments (Mtwo) through the Simultaneous Shaping Technique. The continuous-wave of condensation technique of obturation was used. To all specimens, the restorative space has been made, leaving 5 mm of apical gutta-percha, and postoperative periapical X-rays were performed. The samples were randomly divided into two groups: Group (A): cleansing of the root walls with ultrasonic activation of the irrigants (NEWTRON P5 XS; Satelec Acteon); Group (B): radicular walls wash without ultrasonic activation of endodontic irrigants (NaOCl 5.25% and EDTA 17%). Both dental sample groups were cut longitudinally with a low-speed saw (Isomet); the samples were observed by using a scanning electron microscope (Jeol, Jsm-6060LV) in order to evaluate: (1) the amount of debris/smear layer; (2) the mount of obstruction of dentinal tubules found in the two groups; and (3) evaluation of the presence of gutta-percha. Then, the other five samples each group (with and without ultrasonic activation) were prepared following the same protocol. Then, a universal bonding system (G-Praemio Bond, GC) and a layer of a flowable resin composite (Gaenial Flow, GC) were light-cured and used on top of the prepared root canal walls. The samples were cut in two pieces along the long axis of the root. Then, half sample teeth were kept in an acidic solution (37% HCl) for 48 h in order to completely dissolve dental structures and to have a direct view of resin tags formation under SEM. The other half was prepared to observe the adhesive interface under SEM. The amount of debris was not satisfactory in 9 out of 10 cases in Group B, while in Group A, which has been treated with ultrasounds, the result was either good or great in most of the samples. For the sample group treated with ultrasound, the tubules were evaluated as perfectly clean in 9 out of 10 cases, instead, the results are unsatisfactory for 9 out of 10 cases of group B not treated with ultrasound. Differences between Group A and B were statistically significant. With respect to the presence of debris and tubules obstruction treatment with ultrasonic activation, it offers with no doubt better results. When ultrasonic activation is used in combination with endodontic irrigants, a clean dentin substrate is be obtained for the adhesion of restorative materials, but in order to confirm the findings of this study, further in vivo trials are needed.

scholarly journals Biomechanical Study of Cortical Bone Trajectory Screws in Intervertebral Fixation of Lumbar Tuberculosis

2021 ◽  
Author(s):  
Chen-Wei Zhang ◽  
Shi-Yuan Shi ◽  
De-Xin Hu ◽  
Shen-Ping Hu ◽  
Jin-Ping Hu ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Internal Fixation ◽  
Bone Graft ◽  
Lateral Bending ◽  
Flexion Extension ◽  
Group A ◽  
Group B ◽  
Group D ◽  
State 1 ◽  
Screw Group

Abstract BackgroundWe aimed to explore the biomechanical stability and advantages of cortical bone trajectory (CBT) screws in the treatment of lumbar spine tuberculosis and provide biomechanical basis for the choice of clinical fixation methods. Methods16 pig spine specimens (T12-L5) were selected to simulate the lumbar spine(L2-L3) tuberculosis bone destruction model in vitro. The 16 specimens were randomly divided into 4 groups, and short segments (pedicle screws of the diseased vertebrae) were assigned respectively. Fixation (group A), short-segment fixation (group B), fixation with pedicle screw (group C), fixation with CBT screw (group D), 4 specimens in each group , Each specimen in each group was subjected to biomechanical testing in the state of complete specimen (state 1) and L2-3 spinal tuberculosis model bone graft fusion and internal fixation (state 2). Load each specimen on the spine 3D exercise machine, respectively apply moments of 2N·m, 2.5N·m, 1N·m, 3N·m, meanwhile record the movement of the specimens in the four directions of flexion，extension，lateral bending and torsion ROM, compare Simultaneously analyze each group of ROM. ResultsThe ROMs of flexion, extension, lateral bending, and torsion in group A in state 1 and state 3 modes were （8.47±1.76）°、 （7.01±1.10）°、 （5.03±0.92）°、 （4.48±0.41）°and （4.78±0.07）°、 （2.91±0.16）°、 （2.66±0.09）°、 （2.23±0.05）°; the ROMs of flexion, extension, lateral bending and torsion in group B in state 1 and state 3 modes were （7.32±0.75）°、 （5.35±0.69）°、 （3.44±0.51）°、 （3.36±1.02）°and（3.51±0.29）°、 （1.74±0.04）°、 （1.53±0.31）°、 （1.23±0.08）°; The ROMs of flexion, extension, lateral bending, and torsion in group C in state 1 and state 3 modes were （10.01±0.39）°、 （9.05±0.25）°、 （7.42±1.06）°、 （6.92±1.15）°and （7.21±0.17）°、 （5.07±0.02）°、 （5.12±0.74）°、 （4.58±0.01）°; The ROMs of flexion, extension, lateral bending, and torsion in group D in state 1 and state 3 modes were （9.20±1.37）°、 （7.38±0.88）°、 （6.89±1.22）°、 （6.00±0.52）°and （6.06±0.16）°、 （3.99±0.02）°、 （3.85±0.08）°、 （3.47±0.10）°. The ROM value of each fixed mode group under the state of bone graft fusion and internal fixation was lower than that of the intact state, and the difference was statistically significant (P<0.05)，The t values are 4.531, 5.346, 6.008, 4.149; 9.481, 16.181, 11.814, 4.769; 4.349, 8.002, 4.473, 4.800; 5.041, 4.146, 12.232, 10.58. ConclusionCBT screw disease intervertebral fixation can not only provide sufficient mechanical stability, but also provide stronger stability when using the same fixed segment, and The fixed segments are minimized.

scholarly journals Comparative Effectiveness of Enhanced Recovery After Surgery Program Combined With Single-Incision Laparoscopic Surgery in Colorectal Cancer Surgery: A Retrospective Analysis

2022 ◽  
Vol 11 ◽  
Author(s):  
Changgang Wang ◽  
Haoran Feng ◽  
Xiaoning Zhu ◽  
Zijia Song ◽  
You Li ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Retrospective Study ◽  
Perioperative Management ◽  
Single Incision ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Single Incision Laparoscopic Surgery ◽  
Group A ◽  
Group B

BackgroundRecently, enhanced recovery after surgery (ERAS) has been widely used in the perioperative management of colorectal cancer (CRC). This study aimed to evaluate the safety and feasibility of ERAS combined with single-incision laparoscopic surgery (SILS) in CRC surgery.MethodsThis was a retrospective study of patients with CRC who underwent surgery between April 2018 and April 2020 in Ruijin Hospital(North), Shanghai Jiaotong University School of Medicine. The patients were divided into three groups: group A (n=138), patients who underwent traditional multiport laparoscopic colectomy with conventional perioperative management; group B (n=63), patients who underwent SILS; and group C (n=51), patients who underwent SILS with ERAS.ResultsOverall, 252 participants were included in the retrospective study. The median operation time (min) in group B and group C was shorter than that in group A (group A 134.0 ± 42.5; group B 117 ± 38.9; group C 111.7 ± 35.4, p=0.004). The estimated surgical blood loss (ml) was lower in groups B and C than in group A (group A 165.1 ± 142.2; group B 122.0 ± 79.4; group C 105.2 ± 55.8, p=0.011). The length of surgical incision (cm) was shorter in groups B and C than in group A (group A 7.34 ± 1.05; group B 5.60 ± 0.80; group C 5.28 ± 0.52, p&lt;0.001). The time before first flatus (hours) in group C was shorter than in groups A and B (group A 61.85 ± 21.14; group B 58.30 ± 20.08; group C 42.06 ± 23.72; p&lt;0.001). The days prior to the administration of free oral fluids in group C was shorter than in groups A and B (group A 4.79 ± 1.28; group B 4.67 ± 1.11; group C 2.62 ± 0.64; p&lt;0.001). The days of prior solid diet was less in group C than in groups A and B (group A 7.22 ± 3.87; group B 7.08 ± 3.18; group C 5.75 ± 1.70; p=0.027). The postoperative length of stay (LOS) was less in group C compared with that in groups A and B (group A 9.46 ± 4.84 days; group B 9.52 ± 7.45 days; group C 7.20 ± 2.37 days; p=0.023). The visual analog scale (VAS) scores on day 0, 1, and 2 in groups B and C were lower than those in group A (day 0, p&lt;0.001; day 1, p&lt;0.001; day 2, p=0.002), while the VAS score on day 3 showed no differences in the three groups (group A 1.29 ± 1.38; group B 0.98 ± 1.24; group C 0.75 ± 0.64, p=0.018).ConclusionThe findings suggest that SILS combined with ERAS may be a feasible and safe procedure for CRC surgery because it provides favorable cosmetic results, early dietary resumption, shorter hospital stays, and appropriate control of postoperative pain without increases in complications or readmission rates compared to conventional perioperative care with SILS or conventional laparoscopic surgery(CLS) of CRC. Further prospective randomized controlled studies are needed to enhance evidence-based medical evidence.

scholarly journals LOWER URETERIC STONES EXPULSION;

2017 ◽  
Vol 24 (09) ◽  
pp. 1331-1335
Author(s):  
Khalid Hussain ◽  
Maria Tarique ◽  
Attiq ur Rehman Khan ◽  
Asim Bukhari ◽  
Bilal Akhter ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Oral Treatment ◽  
P Value ◽  
X Rays ◽  
Female Ratio ◽  
Group A ◽  
Insignificant Difference ◽  
The Mean ◽  
Group B ◽  
Trial Setting

Objectives: To compare Tamsulosin versus ESWL for lower ureteric stonesexpulsion. Study Design: Randomized controlled trial. Setting: Outpatient Department ofUrology at Services Hospital, Lahore. Period: January 2015 to December 2015. Material& Methods: Total 50 patients were enrolled in study. Patients were divided into 2 groups.In group A, 25 patients received daily oral treatment of 0.4mg Tamsulosin for 28 days, andin group B, 25 patients were treated with ESWL. A stone-free condition, was defined as thecomplete absence of any stone based on plain abdominal X-rays observed and during followupvisits at the time of treatment of stone was noted. Results: The mean age of the patientswere recorded as 33.20±9.23 years. There were 40(80%) males and 10(20%) females with maleto female ratio of 4:1. Out of 50 patients, 16(32%) presented with hematuria, 3(6%) had feverwhile 31(62%) appeared with no complication status. Out of 50 patients, 21(42%) presentedwith expulsion time 08-14 days in which 14(28%) were from tamsulosin group and 07(14%)were from ESWL group, similarly 19(38%) patients appeared with expulsion time of 15-28 daysin which 10(20%) were from tamsulosin group and 09(18%) were from ESWL group. Statisticallythere is insignificant difference between the groups i.e. p-value=0.28 Ns. Conclusion: Thisstudy suggests that the tamsulosin helps in the earlier clearance of stone fragments andreduces the complications as compared to ESWL.

scholarly journals The effects of preoperative imaging stability studies on intraoperative correction, postoperative observation, and clinical efficacy of adult lumbar spondylolisthesis treatment

2020 ◽  
Author(s):  
Jie Jiang ◽  
Chong Liu ◽  
Guangping Zhang ◽  
Guoyong Xu ◽  
Tuo Liang ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Pedicle Screws ◽  
Preoperative Imaging ◽  
X Rays ◽  
Stability Studies ◽  
Group A ◽  
Vas Scores ◽  
Group B ◽  
Lumbar Spondylolisthesis ◽  
Postoperative Observation

Abstract Background The aim of this study is to explore the use of preoperative imaging stability studies of adult lumbar spondylolisthesis and it's effects on intraoperative correction, postoperative observation, and clinical efficacy. Methods We retrospectively analyzed a total of 104 patients diagnosed with lumbar spondylolisthesis who underwent Posterior lumbar interbody fusion surgery between 2011 and 2014. The qualified patients were divided into two groups; group A (study/unstable group: 52 cases) and group B (control/stable group: 52 cases). Group A was further divided into group A1 (slip instability: 27 cases) and group A2 (angular instability: 25 cases). The preoperative lumbar sagittal plane translation distances and segmental angle of the preoperative lateral X-rays, hyperflexion X-rays, and hyperextension X-rays were measured and compared with their third-day postoperative lateral X-ray, and slip rate. The occurrences of intraoperative or postoperative complications, one-month postoperative follow-up data, including JOA, and VAS scores were access to evaluate the clinical efficacy of the treatment. Results Satisfactory postoperative radiographic correction was recorded in all groups. Better correction and correction was observed in group A1 patients and group B patients who used puller screws compared to those who used normal screws (P < 0.05). However, patients in group A2 who used normal pedicle screws had similar correction as those who used puller screws. The preoperative VAS scores showed that low back and lower extremity pain were higher in A1 and A2 groups compared to group B. However, they were lower one month postoperative. The preoperative JOA scores for the unstable groups (group A1 and A2) were lower than their stable counterpart but higher during the first month postoperative. Our analysis of postoperative complications also revealed no statistically significant difference between groups A1 and B, and groups A2, and B. Conclusions Preoperative imaging stability for adult lumbar spondylolisthesis does not affect intraoperative correction. The use of puller pedicle screws in patients with unstable or stable segmental slippage could achieve better correction and correction than with normal pedicle screws. The preoperative symptoms of patients with unstable segments were worse than their stable counterparts; however, their postoperative recovery was quicker in the first month postoperative.

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