The Use of Crosslinks with Posterior Pedicular Screw Fixation in Lumbar Spondylolisthesis
Abstract Background Pedicle screw instrumentation has gained wide popularity for stabilization of spinal fusions. The use of pedicle screw fixation has increased fusion rates. The placement of segmental pedicle screws and cross-links in short segment posterior pedicle screw constructs has been shown to increase the construct stiffness in some planes. Aim of the Work to evaluate addition of crosslinks to posterior pedicular screw fixation as a modality for surgical management of lumbar spondylolisthesis. Patients and Methods This study included 50 patients with lumbar spondylolisthesis divided into two groups according to the surgical approach used in treatment. One group with Posterolateral fixation by transpedicular screws and rods and the other Group had cross-links added to the posterior construct. Results There was no significant difference in postoperative JOA score between both groups, while comparing mean of preoperative and postoperative JOA scores in each group showed a significant rise of the score in each group after surgery. There was no significant difference in the variables of postoperative sagittal alignment between both groups, while comparing mean of preoperative and postoperative sagittal alignment variables in each group revealed a significant reduction of the disc height percent in both groups, and in slip angle and lumbar lordosis angle in group B. Regarding postoperative rate and degree of improvement in the studied groups, there was no significant difference in the rate and degree of improvement between both groups. Conclusion no appreciable benefit from using cross-links was found in short-segment fixation of lumbar spondylolisthesis, where there’s no or little torsional instability encountered.